title: Embolization of renal arteries before transplantation in patients with polycystic kidney disease: a single institution long-term experience.
abstract: OBJECTIVE
  We aimed to retrospectively assess the long-term safety and efficacy of embolization of renal arteries (ERA) in patients with polycystic kidney disease (PKD) before renal transplantation.
  
  
  METHODS
  Between January 2008 and November 2013, 82 ERA procedures were performed on 76 kidneys in 73 patients (mean age 53 years, range: 34-72). All patients had terminal-stage PKD and were under dialysis and on the renal transplant waiting list with a temporary contraindication due to excessive renal volume.
  
  
  RESULTS
  ERA was considered successful in 89.5% (68/76) of embolized kidneys, meaning that the temporary contraindication for transplantation could be withdrawn for 65 patients (on average 5.6 months, range: 2.8-24.3, after ERA). Mean volume reduction was 40 (range: 2-69) at 3 months and 59% (35-86) thereafter (both p < 0.001). Post-embolization syndrome occurred after 15 of 82 procedures (18.3%). The severe complication rate was 4.9%. Forty-three (67.7%) transplantations were successfully conducted after ERA, with a mean follow-up of 26.2 months (range: 1.8-59.5), and the estimated 5-year graft survival rate was 95.3% [95% CI: 82.7-98.8].
  
  
  CONCLUSIONS
  ERA is a safe and effective alternative to nephrectomy before renal transplantation in patients with PKD.
  
  
  CONCLUSIONS
  • Embolization of non-functioning polycystic kidneys allowed transplantation in 89.5% of cases. • Technical failure rate was 7.9% after embolization, irrespective of the technique used. • Post-embolization syndrome occurred after 18.3% of the procedures. • A low rate of severe complications (4.9%) was observed after renal embolization.
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Petitpierre
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France. francois.cornelis@chu-bordeaux.fr.
authors.forename: F
authors.initials: F
authors.lastname: Cornelis
authors.affiliation: Department of Nephrology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: L
authors.initials: L
authors.lastname: Couzi
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Lasserre
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Tricaud
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Bras
authors.affiliation: Department of Nephrology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Merville
authors.affiliation: Department of Urology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Combe
authors.affiliation: Department of Urology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Ferriere
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Grenier
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000628:therapy; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D009929:Organ Size; D061214:Patient Safety; D007690:Polycystic Kidney Diseases / Q000473:pathology / Q000628:therapy*; D011183:Postoperative Complications / Q000517:prevention & control; D012077:Renal Artery; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
keywords: Embolization; Polycystic Kidney Disease; Safety; Survival; Transplantation