Biopsy-related hemorrhage of renal allografts treated by percutaneous superselective segmental renal artery embolization.
BACKGROUND
Biopsy-related vascular injuries in renal transplants are rare, but they can lead to dramatic clinical symptoms prompting immediate treatment. Transcatheter embolization is a minimally invasive technique used to treat some forms of arterial bleeding. This study evaluated the efficacy of this technique in iatrogenic biopsy-related vascular lesions in renal allografts.


METHODS
Over the last eight years, six patients with severe renal hemorrhage were admitted to the angiography department of our hospital for evaluation and possible further treatment. All of them had a history of previous biopsy of a transplanted kidney. They all presented with clinical signs of hemodynamic instability. Angiographic investigation of the kidneys preceded further intervention in all cases. All underwent hyperselective embolization of the specific bleeding vessel with the use of microcoils and/or gelfoam particles.


RESULTS
Successful embolization of the feeding artery could be performed in all patients. Superselective segmental renal artery embolization had a successful outcome concerning a steady renal function and a stable clinical course. No complications occurred.


CONCLUSIONS
Transcatheter embolization is a safe and efficient endovascular technique to treat biopsy-related vascular injuries in renal transplants. Immediate clinical success and significant benefit in renal function can be obtained, and the longevity of the allograft after successful embolization mainly depends on the natural outcome.
Pappas
P
P
Department of Urology, University of Athens, Athens, Greece.
Constantinides
C
C
Leonardou
P
P
Zavos
G
G
Boletis
J
J
Koutalellis
G
G
Adamakis
I
I
D000293:Adolescent; D000328:Adult; D021721:Balloon Occlusion; D001706:Biopsy; D005260:Female; D006417:Hematuria / Q000209:etiology; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D012077:Renal Artery