Renal artery embolization of non-functioning graft: an effective treatment for graft intolerance syndrome
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VASCULAR AND INTERVENTIONAL RADIOLOGY
Renal artery embolization of non‑functioning graft: an effective treatment for graft intolerance syndrome Matteo Fantoni1 · Carla Marcato2 · Andrea Ciuni1 · Carlo Pellegrino3 · Umberto Russo1 · Riccardo Zannoni1 · Ilaria Paladini2 · Andrea Andreone2 · Massimo De Filippo1 Received: 9 January 2019 / Accepted: 12 August 2020 © Italian Society of Medical Radiology 2020
Abstract Background Percutaneous renal artery embolization is a valid non-invasive technique alternative to nephrectomy for patients with symptomatic non-functioning allograft (graft intolerance syndrome—GIS). The purpose of this article is to report the experience of our centre. Methods We analysed retrospectively 15 patients with symptomatic non-functioning renal allograft treated with percutaneous embolization from 2003 to 2017. Occlusion was obtained with the injection of calibrated microspheres of increasing size (from 100 to 900 μm) and completed with 5 to 8 mm metal coils placement in the renal artery. Results Technical success was achieved in all cases at the end of the procedure. Clinical success was obtained in 11 patients (73%). In four cases, nephrectomy was necessary: in one case because of septic fever and in three cases because of GIS persistence. In one case, it was possible to perform another procedure to embolize a perirenal collateral from a lumbar artery. Four patients (27%) reported minor complications which spontaneously resolved during the hospital stay. Conclusions According to the scientific literature, we believe that, in selected patients, percutaneous renal artery embolization is a valid treatment option for GIS thanks to its efficacy, repeatability, minimal invasiveness and the absence of severe complications. Keywords Graft intolerance syndrome · Embolization · Kidney · Renal artery
Introduction 15–20% Renal grafts lose their function approximately 5 years after transplantation, resulting in patients returning to haemodialysis. These patients usually proceed to a
gradual withdrawal of immunosuppressive therapy, justified by the high infectious, neoplastic and cardiovascular risks associated with anti-rejection drugs. After immunosuppression interruption, if no graft-related symptoms occur,
* Andrea Ciuni [email protected]
Andrea Andreone [email protected]
Matteo Fantoni [email protected]
Massimo De Filippo [email protected]
Carla Marcato [email protected]
1
Department of Medicine and Surgery, Unit of Radiologic Science, University of Parma, Maggiore Hospital, Via Gramsci 14, Parma, Italy
2
Department of Medicine and Surgery, Unit of Interventional Radiology, University of Parma, Maggiore Hospital, Via Gramsci 14, Parma, Italy
3
Department of Medicine and Surgery, Unit of General Surgery, University of Parma, Maggiore Hospital, Via Gramsci 14, Parma, Italy
Carlo Pellegrino [email protected] Umberto Russo [email protected] Riccardo Zannoni [email protected] Ilaria Paladini [email protected]
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