Embolism due to cholesterol crystals in a kidney transplant patient

Abstract

Atheroembolism is characterized by the occlusion of small arteries with cholesterol emboli arising from atheromatous plaques eroding large arteries. This complication occurs in patients with a history of atherosclerosis and triggers causes such as endovascular procedures or the initiation of anticoagulant treatment. The proximity of the kidneys to the abdominal Aorta and the large renal blood supply makes the kidney a target organ for it.

We present a patient with a history of hepato-renal polycystic disease who received a kidney transplant with graft loss due to cortical necrosis secondary to cholesterol atheroembolism. This pathology is usually underdiagnosed due to suspicion of rejection or toxicity due to calcineurin inhibitors (CNI). Treatment is limited to the use of corticosteroids and lipid-lowering agents.

Despite therapeutic efforts, the patient progressed with graft loss.