Intraoperative coil embolization reduces transplant nephrectomy transfusion requirement.
Transplant nephrectomy for failed renal transplants can be challenging. Patients often have numerous comorbidities, and the procedure may be associated with considerable blood loss. This study was performed to determine if intraoperative coil embolization of the transplant renal artery reduces blood loss associated with transplant nephrectomy. Data were collected retrospectively on 13 consecutive transplant nephrectomies performed immediately following coil embolization and compared with the 13 most recently performed consecutive transplant nephrectomies without coil embolization. The groups were compared for operative time, estimated blood loss, and transfusion requirements. Mean age was 45 in both groups. There were no major complications in either group. Operative times were not significantly different, although open operative time was reduced in the embolization group (113 vs 96 minutes). Estimated blood loss was 465 mL versus 198 mL (P = .035); packed red blood cell requirements during the operation and subsequent 48 hours were 1.85 units versus 0.31 units (P = .008) and during the operation and subsequent hospital stay were 2.3 units versus 0.69 units (P = .027) in the nonembolized group and embolized group, respectively. Intraoperative embolization of the transplant renal artery immediately prior to surgery facilitates transplant nephrectomy by significantly reducing intraoperative blood loss and transfusion requirements while slightly reducing open operative time.
Neschis
David G
DG
Divisions of Vascular Surgery, University of Maryland Medical Cebter, Baltimore, Maryland 21201, USA. dneschis @smail.umaryland.edu
Gutta
Rao
R
Al-Qudah
Hosam S
HS
Bartlett
Stephen T
ST
Philosophe
Benjamin
B
Schweitzer
Eugene J
EJ
Flinn
William R
WR
Campos
Luis
L
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012077:Renal Artery; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome