Abstract
Percutaneous interventional diagnostic and therapeutic techniques are commonly employed when post-renal transplantation complications develop. Postoperative complications are less than 10%, but when they do occur, they can have a significant impact on morbidity and mortality. In addition to routine surveillance biopsies, patients with graft dysfunction typically undergo percutaneous biopsy as a diagnostic tool. Advances in interventional radiology techniques to treat vascular and urologic issues have obviated the need for surgical revision. Vascular complications include arterial and venous stenosis, arterial and venous thrombosis, arteriovenous fistula, and pseudoaneurysm. Nonvascular complications consist of urologic issues such as ureteral obstruction, including ureteral strictures and stones, pyeloureteritis cystica, and perigraft fluid collections, including urinoma, hematoma, seroma, abscess, or lymphocele.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Kasiske B, Vazquez M, Harmon W, Brown R, Danovitch G, Gaston R. Recommendations for the outpatient surveillance of renal transplant recipients. J Am Soc Nephrol. 2000;11(Suppl 15):S1–86.
Racusen LC, Solez K, Colvin RB, et al. The Banff 97 working classification of renal allograft pathology. Kidney Int. 1999;55(2):713–23.
Patel MD, Phillips CJ, Young SW, et al. US-guided renal transplant biopsy: efficacy of a cortical tangential approach. Radiology. 2010;256:290–6.
LaBerge JM. Interventional management of renal transplant arteriovenous fistula. Semin Interv Radiol. 2004;21(4):239–46.
Bach D, Wirth C, Schott G, Hollenbeck M, Grabensee B. Percutaneous renal biopsy: 3 years of experience with the biopsy gun in 761 cases—a survey of results and complications. Int Urol Nephrol. 1999;31:15–22.
Copelan A, George D, Kapoor B, et al. Iatrogenic-related transplant injuries: the role of the interventional radiologist. Semin Intervent Radiol. 2015;32:133–55.
Martinez T, Palomares M, Bravo JA, et al. Biopsy induced arteriovenous fistula and venous aneurysm in a renal transplant. Nephrol Dial Transplant. 1998;13:2937–9.
Ray CE Jr. Renal embolization. Semin Interv Radiol. 2001;18:37–45.
Maleux G, Messiaen T, Stockx L, Vanrenterghem Y, Wilms G. Transcatheter embolization of biopsy-related vascular injuries in renal allografts. Long-term technical, clinical and biochemical results. Acta Radiol. 2003;44(1):13–7.
Srivastava A, Kumar J, Sharma S, et al. Vascular complication in live related renal transplant: an experience of 1945 cases. Indian J Urol. 2013;29:42–7.
Chen W, Kayler LK, Zand MS, et al. Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy. Clin Kidney J. 2015;8:71–8.
Pappas P, Zavos G, Kaza S, et al. Angioplasty and stenting of arterial stenosis affecting renal transplant function. Transplant Proc. 2008;40(5):1391–6.
Kobayashi K, Censullo ML, Rossman LL, et al. Interventional radiologic management of renal transplant dysfunction: indications, limitations, and technical considerations. Radiographics. 2007;27:1109–30.
Rajan DK, Stavropoulos SW, Shlansky-Goldberg RD. Management of transplant renal artery stenosis. Semin Intervent Radiol. 2004;21(4):259–69.
Biederman DM, Fischman AM, Titano JJ, et al. Tailoring the endovascular management of transplant renal artery stenosis. Am J Transplant. 2015;15:1039–49.
Estrada CC, Musani M, Darras F, et al. 5 years experience with drug eluting and bare metal stents as primary intervention in transplant renal artery stenosis. Transplantation Direct. 2017;3:e128.
Hanna RF, Hao F, Kraus G, et al. Renal transplant arterial stenosis treated with bare-metal versus drug-eluting stents: comparison of treatment outcomes. Transplant Proc. 2015;47:2881–5.
Merkus JW, Van Asten WN, Hoitsma AJ, et al. Iliac artery stenosis after kidney transplantation. Acta Chir Belg. 1993;93(5):242–8.
Rerolle JP, Antoine C, Raynaud A, et al. Successful endoluminal thrombo-aspiration of renal graft venous thrombosis. Transpl Int. 2000;13:82–6.
Bakir N, Sluiter WJ, Ploeg RJ, van Son WJ, Tegzess AM. Primary renal graft thrombosis. Nephrol Dial Transplant. 1996;11(1):140–7.
Ortega Herrera R, Medina Benítez A, Hernández Abad MJ. Renal vein partial thrombosis in 3 recipients of kidney transplantation. Arch Esp Urol. 2000;53(1):45–8.
Giustacchini P, Pisanti F, Citterio F, De Gaetano AM, Castagneto M, Nanni G. Renal vein thrombosis after renal transplantation: an important cause of graft loss. Transplant Proc. 2002;34(6):2126–7.
Donckier V, De Pauw L, Ferreira J, et al. False aneurysm after transplant nephrectomy: report of two cases. Transplantation. 1995;60:303–4.
Fananapazir G, Hannsun G, Wright LA, Corwin MT, Troppmann C. Diagnosis and management of transplanted kidney extrarenal pseudoaneurysms: a series of four cases and a review of the literature. Cardiovasc Intervent Radiol. 2016;39:1649–53.
Low G, Crockett AM, Leung K, et al. Imaging of vascular complications and their consequences following transplantation in the abdomen. Radiographics. 2013;33:633–52.
Obed A, Uihlein DC, Zorger N, et al. Severe renal vein stenosis of a kidney transplant with beneficial clinical course after successful percutaneous stenting. Am J Transplant. 2008;8:2173–6.
Jones G, Tibballs J, Al-Akraa M, et al. Iliac vein stenosis as a reversible cause of renal transplant dysfunction. Nephrol Dial Transplant. 2004;19:2415–6.
Kim JH, Bae SM, Park S. Ipsilateral leg swelling after renal transplantation as an alarming sign of iliac vein stenosis. Kidney Res Clin Pract. 2014;33:217–21.
Cercueil JP, Chevet D, Mousson C, et al. Acquired vein stenosis of renal allograft—percutaneous treatment with self-expanding metallic stent. Nephrol Dial Transplant. 1997;12:825–6.
Streeter EH, Little DM, Cranston DW, Morris PJ. The urological complications of renal transplantation: a series of 1535 patients. BJU Int. 2002;90(7):627–34.
Shoskes DA, Hanbury D, Cranston D, Morris PJ. Urological complications in 1,000 consecutive renal transplant recipients. J Urol. 1995;153(1):18–21.
Kumar S, Ameli-Renani S, Hakim A, Jeon JH, Shrivastava S, Patel U. Ureteral obstruction following renal transplantation: causes, diagnosis and management. Br J Radiol. 2014;87:20140169.
Kumar S, Jeon JH, Hakim A, Shrivastava S, Banerjee D, Patel U. Long-term graft and patient survival after balloon dilation of ureteric stenosis after renal transplant: a 23-year retrospective matched cohort study. Radiology. 2016;281(1):301–10. https://doi.org/10.1148/radiol.2016151629.
Aytekin C, Boyvat F, Harman A, Ozyer U, Colak T, Haberal M. Percutaneous therapy of ureteral obstructions and leak after renal transplantation: long-term results. Cardiovasc Intervent Radiol. 2007;30(6):1178–84.
Berli JU, Montgomery JR, Segev DL, et al. Surgical management of early and late ureteral complications after renal transplantation: techniques and outcomes. Clin Transplant. 2015;29(1):26–33.
Fontaine AB, Nijjar A, Rangaraj R. Update on the use of percutaneous nephrostomy/balloon dilation for the treatment of renal transplant leak/obstruction. J Vasc Interv Radiol. 1997;8(4):649–53.
Lojanapiwat B, Mital D, Fallon L, et al. Management of ureteral stenosis after renal transplantation. J Am Coll Surg. 1994;179(1):21–4.
Kawashima A, Vrtiska TJ, Leroy AJ, et al. CT urography. Radiographics. 2004;24(Suppl 1):S35–54.
Joffre F, Otal P, Soulie M. Radiological imaging of the ureter. Springer; 2003. ISBN: 3540655212.
Petersen RO, Sesterhenn IA, Davis CJ. Urologic pathology. Farrar, Straus, and Giroux; 2009. ISBN: 0781753430.
Beland MD, Gervais DA, Levis DA, Hahn PF, Arellano RS, Mueller PR. Complex abdominal and pelvic abscesses: efficacy of adjunctive tissue-type plasminogen activator for drainage. Radiology. 2008;247(2):567–73.
Johnson SP, Berry RS. Interventional radiological management of the complications of renal transplantation. Semin Interv Radiol. 2001;18:47–58.
Akbar SA, Jafri SZ, Amendola MA, Madrazo BL, Salem R, Bis KG. Complications of renal transplantation. RadioGraphics. 2005;25(5):1335–56.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Vu, C.T., Doskocil, B., Sheen, L. (2018). Renal Transplant Interventions. In: Fananapazir, G., Lamba, R. (eds) Transplantation Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-75266-2_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-75266-2_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-75264-8
Online ISBN: 978-3-319-75266-2
eBook Packages: MedicineMedicine (R0)