Early Endovascular Treatment in Renal Transplant: A Case Report

Abstract

Background: A 46-year-old female kidney transplant recipient developed acutely impaired graft function on the first postoperative day and received early endovascular treatment. Case report: The patient underwent living donor kidney transplantation from a sister in January 2011. She showed good diuresis during the early hours, followed by abruptly decreased urine output. Ultrasound examination suggested thrombosis of the intrarenal arteries or renal artery stenosis. Arteriography showed no stenosis at the site of anastomosis, but the presence of faint contrast filling the intrarenal arteries. She received intrarenal thrombolysis with 15 mg of recombinant tissue plasmin activator (rTPA), balloon angioplasty and a post anastomotic intra luminal renal artery stent with good perfusion and complete graft recovery. Conclusion: Early endovascular treatment is a possible therapeutic option in acute vascular renal transplant complications like intrarenal arterial thrombosis or renal artery stenosis. Excellent results were achieved with the procedure in the present case.