Hazard of percutaneous transluminal dilation in renal transplant arterial stenosis

Percutaneous transluminal dilation of a transplant renal artery was attempted in a patient. The renal artery was perforated by the balloon catheter during the procedure. Despite prompt surgical intervention, the kidney was lost because of irreversible ischemia. This experience is a warning that irreversible ischemia can occur with a transplant kidney if an occlusive complication occurs after percutaneous transluminal dilation. Since the warm ischemic time can exceed the surgical approach and repair, the renal transplant can be lost, and treatment of the patient will resume with long-term hemodialysis. Surgical correlation is a more predictable method, which still must be considered as the treatment of a renal allograft artery stenosis.