scholarly journals Massive retroperitoneal haemorrhage after retrograde pyelogram in end-stage kidneys: A case report

2020 ◽  
Vol 29 (4) ◽  
pp. 256-259
Author(s):  
Xinyan Yang ◽  
Valerie Huei Li Gan ◽  
Lay Guat Ng ◽  
Henry Sun Sien Ho ◽  
Edwin Jonathan Aslim
Keyword(s):  
Deceased Donor ◽  
Upper Urinary Tract ◽  
Deceased Donor Kidney ◽  
Retrograde Pyelogram ◽  
History Of ◽  
Retroperitoneal Haemorrhage ◽  
Intrarenal Pressure ◽  
End Stage ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Severe retroperitoneal haemorrhage after retrograde pyelogram (RPG) is rare and has not been reported in the literature. One of the few indications for performing RPG in end-stage kidneys is evaluation of the upper urinary tract for malignancy. We present a rare case of massive retroperitoneal haemorrhage in a 58-year-old man, with a history of deceased donor kidney transplantation for end-stage kidney disease (ESKD), following bilateral RPG for the evaluation of urothelial cancer. The bleeding was successfully stopped with renal artery angioembolisation. This case demonstrates the importance of exercising extra caution when performing endoscopic procedures in patients with ESKD and keeping the intrarenal pressure as low as possible.

scholarly journals 515 How Has ‘Montgomery’ Changed the Way We Document Risks on Consent Forms for Deceased Donor Kidney Transplantation? A Single-Centre Audit and Re-Audit

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A M Hussein ◽  
C J Callaghan
Keyword(s):  
Gold Standard ◽  
Deceased Donor ◽  
Consent Form ◽  
Donor Kidney ◽  
Consent Forms ◽  
Legal Case ◽  
Deceased Donor Kidney ◽  
Single Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Abstract Introduction The 2015 Montgomery case changed the remit of risk discussions required during the consent process. This audit reviewed single kidney transplant (SKT) consent forms to establish which risks are documented, and whether this legal case affected discussions. Following the audit, we introduced a pre-printed consent form and closed the audit loop by assessing its uptake. Method Trust paper consent forms for all patients aged 50+ who received a deceased donor SKT in our centre in 2014 (n = 58; pre-Montgomery) and 2017 (n = 70; post-Montgomery) were reviewed to see if 20 perceived ‘gold standard’ risks were documented. A pre-printed procedure-specific consent form including all gold standard risks was then introduced in July 2019. A re-audit reviewed the case-notes of every alternate recipient aged 50+ of a deceased donor SKT from 01/08/19 to 29/02/20 to check if the pre-printed form was used. Results Overall, 53% of the 20 ‘gold standard’ risks were documented in 2014 versus 59% in 2017 (p = 0.55). There was a 91% uptake of the pre-printed consent form. Discussion This audit established the importance of using a pre-printed consent form to standardise risk discussions We propose that pre-printed procedure-specific forms should be encouraged throughout the NHS to support ‘Montgomery-appropriate’ consent discussions.

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