Percutaneous renal artery embolization of nonfunctioning allograft: preliminary experience

Percutaneous renal artery embolization has been introduced as an alternative to nephrectomy for patients with a nonfunctioning allograft and Graft Intolerance Syndrome. The symptoms resulting from this syndrome include fever, local pain, hypertension, and hematuria. From April 2003 to October 2003, 5 patients were treated with this technique. The intraparenchymal renal arteries were embolized by injection of calibrated tris-acryl gelatin microspheres of increasing size (from 100-330 to 700-900 microm) and completed with the insertion of 5-mm-8-mm steel coils in the renal artery. The procedure was well tolerated in all cases; no major complications occurred. In 3 patients, the symptoms disappeared immediately. In 1 patient, it was necessary to perform a second embolization due to collateral circulation developing from a lumbar artery; this further procedure resolved the symptoms. In the last case, the patient underwent nephrectomy because of septic fever. In conclusion, patients with this syndrome refractory to medical treatment may be treated by the effective and minimally invasive procedures of percutaneous allograft artery embolization with no significant short-term or late complications.