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Renal allograft failure due to emphysematous pyelonephritis: successful non‐operative management and proposed new classification scheme based on literature review
Author(s) -
AlGeizawi S.M.T.,
Farney A.C.,
Rogers J.,
Assimos D.,
Requarth J.A.,
Doares W.,
Winfrey S.,
Stratta R.J.
Publication year - 2010
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2010.00538.x
Subject(s) - medicine , nephrectomy , sepsis , intensive care medicine , kidney , classification scheme , kidney transplantation , renal function , transplantation , disease , kidney disease , surgery , computer science , information retrieval
S.M.T. Al‐Geizawi, A.C. Farney, J. Rogers, D. Assimos, J.A. Requarth, W. Doares, S. Winfrey, R.J. Stratta. Renal allograft failure due to emphysematous pyelonephritis: successful non‐operative management and proposed new classification scheme based on literature review.
Transpl Infect Dis 2010: 12: 543–550. All rights reserved Abstract: Emphysematous pyelonephritis (EPN) is a rare necrotizing infection of the kidney caused by gas‐forming organisms, usually occurs in diabetic patients, and often requires nephrectomy for effective therapy. EPN is rarely reported in renal allografts, with only 20 cases found in the English literature. We report herein a case of EPN in a transplanted kidney resulting in acute renal failure and sepsis. The patient was managed non‐operatively with subsequent recovery of renal allograft function. Based on this experience and a review of the literature, we suggest an amended classification system for EPN in kidney transplantation to plan and guide treatment options accordingly. However, the scarcity of this disease process, coupled with the lack of prospective validation of the new classification scheme, prevents drawing definitive conclusions regarding optimal management strategies including the role and timing of allograft nephrectomy.