Delayed Nephron Sparing Surgery for Grade IV Renal Injury

Table 1

AAST Organ Injury Severity Score for the kidney (table derived from Santucci and McAninch [5]).

Grade^a	Type	Description
I	Contusion	Microscopic or gross hematuria, urologic studies normal
II	Hematoma	Subcapsular, nonexpanding without parenchymal laceration
	Hematoma	Nonexpanding perirenal hematoma confirmed to renal retroperitoneum
	Laceration	Parenchymal depth of renal cortex <1.0 cm without urinary extravasation
III	Laceration	Parenchymal depth of renal cortex <1.0 cm without collecting system rupture or urinary extravasation
IV	Laceration	Parenchymal laceration extending through renal cortex, medulla, and collecting system
	Vascular	Main renal artery or vein injury with contained hemorrhage
V	Laceration	Completely shattered kidney
	Vascular	Avulsion of renal hilum that devascularizes kidney

^aAdvanced one grade for bilateral injuries up to Grade III.