CEN Case Reports

, Volume 7, Issue 1, pp 5–8 | Cite as

Hemorrhagic shock due to bleeding from an arteriovenous fistula after allograft biopsy in a kidney transplant recipient: a case report

  • Akihiro Ryuge
  • Masahiko Yazawa
  • Kazuki Kitajima
  • Ryuto Nakazawa
  • Hideo Sasaki
  • Tatsuya Chikaraishi
  • Yugo Shibagaki
Case Report


Arteriovenous fistula (AVF) after allograft biopsy occurs in 1.6–8.3% of kidney transplant patients and most cases remain asymptomatic. Here, we report a case of hemorrhagic shock in a kidney transplant recipient following bleeding from an AVF after graft biopsy. Immediate intensive care including angiographic embolization saved the patient and the allograft. A 62-year-old woman with end-stage renal disease caused by diabetic nephropathy underwent ABO-incompatible kidney transplantation. No complications occurred in the early postoperative period. However, serum creatinine levels did not decrease sufficiently and decreased graft diastolic blood flow was noted on ultrasound. Therefore, at 14 days after kidney transplantation, allograft biopsy was performed to elucidate the cause of allograft dysfunction. At 5 days after allograft biopsy, the patient developed hemorrhagic shock caused by bleeding from an AVF in the allograft. We immediately performed angiographic embolization, and her vital signs improved without deterioration in renal function. AVF can cause hemorrhagic shock, and angiographic embolization is effective for treating it.


Allograft biopsy Arteriovenous fistula Hemorrhagic shock Angiographic embolization 


Compliance with ethical standards

Conflict of interest

All the authors have declared no competing interests.

Human and animal rights statement

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in this case report.




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Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  • Akihiro Ryuge
    • 1
    • 2
  • Masahiko Yazawa
    • 2
  • Kazuki Kitajima
    • 3
  • Ryuto Nakazawa
    • 3
  • Hideo Sasaki
    • 3
  • Tatsuya Chikaraishi
    • 3
  • Yugo Shibagaki
    • 2
  1. 1.Department of NephrologyNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Nephrology and HypertensionSt. Marianna University School of MedicineKawasakiJapan
  3. 3.Department of UrologySt. Marianna University School of MedicineKawasakiJapan

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