Urologic complications following renal transplantation: role of interventional radiologic procedures

Seventy renal transplant recipients with suspected urologic problems underwent interventional radiologic procedures for further diagnosis and treatment. We found that 28 patients did not have urologic complications. The other 42 patients demonstrated a total of 62 complications, including 40 cases of obstruction, 12 cases of extravasation, and ten collections of pararenal fluid. Ultrasound and nuclear renal scans with both technetium-99m DTPA and iodine-131 hippuran were found to be sensitive screening techniques for the detection of these complications. Fifty of the 51 abnormalities were detected using a combination of these techniques. Percutaneous methods alone were successful in treating 15 urinary obstructions, eight pararenal fluid collections, and five urinary extravasations. We encountered six procedure-related complications, and there were three delayed infectious complications that were related to indwelling nephrostomy tubes. One of these three complications resulted in death. The results of our study suggest that invasive radiologic procedures can be safely used to diagnose and treat urologic complications in renal transplant recipients.