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Related Experiment Video

Updated: Jul 5, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

Cholesterol embolization in a renal graft.

Undine Ott¹, Jens Gerth, Herman-Josef Gröne

¹Department of Internal Medicine III, University of Jena, Jena, Germany.

Clinical Transplantation

|May 22, 2008

Summary

Cholesterol emboli can affect kidney transplants, causing delayed graft function. However, if the source is the recipient, kidney allograft survival is often good, unlike emboli from the donor.

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Last Updated: Jul 5, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

Area of Science:

Nephrology
Transplantation
Cardiovascular Medicine

Background:

Cholesterol embolization syndrome (CES) typically affects native kidneys, leading to renal failure.
CES in renal allografts is uncommon but associated with atherosclerosis in recipients or donors.
CES can manifest as delayed graft function post-transplantation.

Observation:

A 65-year-old male recipient experienced delayed graft function in his renal allograft.
The recipient had significant atherosclerosis in his external iliac artery, a potential source of emboli.
The patient required temporary dialysis post-transplantation.

Findings:

A second biopsy confirmed the absence of cholesterol emboli in the allograft.
Renal function improved, with serum creatinine at 260 micromol/L six months post-transplant.
Distinguishing the source of emboli (recipient vs. donor) is critical for prognosis.

Implications:

Cholesterol embolization should be considered in the differential diagnosis of primary renal allograft non-function or dysfunction.
Recipient-origin emboli are associated with better allograft survival compared to donor-origin emboli.
Donor-origin emboli may lead to more extensive disease and higher rates of graft loss, possibly due to procurement trauma or donor atherosclerosis.