Nonfunctioning renal allograft embolization as an alternative to Graft nephrectomy: Report on seven years' experience

• Published in: Cardiovascular and interventional radiology 2003-01, Vol.26 (1), p.37-39
• Main Authors: ATAR, Eli, BELENKY, Alexander, NEUMAN-LEVIN, Margalit, YUSSIM, A, BAR-NATHAN, Nathan, BACHAR, Gil N
• Format: Article
• Language: English
• Subjects: ABSCESSES; Adolescent; Adult; ARTERIES; Biological and medical sciences; Child; DISEASE INCIDENCE; Diseases of the urinary system; Embolization, Therapeutic; Ethanol - therapeutic use; Female; Graft Rejection - therapy; GRAFTS; Humans; Kidney Transplantation; KIDNEYS; Male; Medical sciences; Middle Aged; MORTALITY; NEPHRECTOMY; PATIENTS; Polyvinyls - therapeutic use; PVA; RADIOLOGY AND NUCLEAR MEDICINE; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Treatment Outcome
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-002-1976-z

Graft nephrectomy is the treatment of choice in patients with graft intolerance syndrome, but it is associated with high morbidity and mortality rates. Renal vascular embolization has been suggested as a possible alternative. The aim of this study was to evaluate the efficacy and safety of arterial embolization of these nonfunctioning transplanted kidneys. Twenty-six transplanted kidneys in 25 patients with irreversible renal graft rejection and graft intolerance who underwent arterial embolization at our center from August 1994 to April 2001 were analyzed for procedural success and long-term outcome. Embolization was performed with absolute alcohol or with polyvinyl alcohol (Ivalon) and coils. Twenty-four of the 26 (92%) procedures were technically successful, but in one patient only partial occlusion of one of two renal arteries was achieved, and in another the renal artery was already completely occluded. There were two major complications: emphysematous pyelonephritis necessitating nephrectomy and groin abscess that was drained. Follow-up ranged from 8 to 84 months. Clinical success was achieved in 24 of the 26 procedures (92%), and only in one patient did embolization fail to relieve the symptoms, and nephrectomy was performed 3 months later. Renal vascular embolization is a simple, safe and effective technique for the treatment of nonfunctioning renal allografts associated with graft intolerance syndrome. We suggest that it be considered the treatment of choice.