Ablation of non functioning renal allograft by embolization: a valid alternative to graft nephrectomy?
OBJECTIVE
Removal of transplant for the treatment of graft intolerance syndrome (GIS) is an invasive procedure with high risk, often performed in patients with poor general conditions. Renal allograft embolization is a recent alternative treatment to surgical nephrectomy. The aim of this study was to evaluate the efficacy and safety of allograft embolization in a series of patients with GIS.


METHODS
The study included 12 patients (9 males and 3 females) with irreversible renal graft rejection and GIS. All patients were in hemodialysis and they have not responded to medical treatment. Infection was ruled out by blood and urine cultures. The embolization was performed using polyvinyl alcohol particles and steel coils. Vascular access was obtained via femoral artery puncture in all the patients. Before starting embolization at the puncture site local anaesthesia was performed.


RESULTS
Eleven of the twelve procedures were technically successful, but in one patient a second treatment was necessary, after a month, for the presence of collateral perirenal circulation caused hematuria. There were no major complications and the mean hospital stay was 5 days.


CONCLUSIONS
The graft embolization is a simple, safe and effective technique that permits non-surgical ablation of a non-functioning renal allograft in a significant number of patients.
Solinas
Andrea
A
Department of Renal Pathology, Unit of Urology, San Michele Hospital, Cagliari, Italy. sol.andrea@tiscali.it
De Giorgi
Franco
F
Frongia
Mauro
M
D000328:Adult; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006084:Graft Rejection / Q000628:therapy*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D011142:Polyvinyl Alcohol / Q000008:administration & dosage; D012189:Retrospective Studies; D013193:Stainless Steel; D014184:Transplantation, Homologous
D013193:Stainless Steel; D011142:Polyvinyl Alcohol