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Percutaneous embolization of the failed renal allograft in patients with graft intolerance syndrome
C González-Satué1, L Riera, E Franco
1Service of Urology and Radiology, Ciutat Sanitaria i Universitaria de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain. cgs@pulso.com
Objective:
To analyse the circumstances, results and complications of percutaneous embolization in failed renal grafts that are not tolerated, to avoid surgical graft removal in selected patients.
Patients And Methods:
The study included 33 patients (mean age 42 years, SD 13.9) whose renal grafts failed between 1990 and 1999. The patients underwent percutaneous embolization of their renal transplant for graft intolerance syndrome. The allograft was left in situ after failure for a mean (SD) of 9.9 (6.5) months. The subsequent hospital stay, the appearance of complications and the final results were assessed.
Results:
Post-embolization syndrome (fever for 2-5 days) appeared in 20 (61%) of the patients; the clinical intolerance resolved in 28 (85%). The embolization was unsuccessful in five of the 33 patients (15%) and they required graft removal. The mean (SD) hospital stay was 5 (2) days; there were no major complications from graft embolization.
Conclusions:
Graft embolization avoids kidney removal in many patients with failed and rejected transplants, with low rates of morbidity. Surgical graft nephrectomy was useful when graft intolerance syndrome persisted after embolization.