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Intervention in renal transplantation

Department of Radiology, North Glasgow Hospitals University NHS Trust, Gartnavel Hospital, 1053 Great Western Road, Glasgow G12 OYN, UK

• Interventional radiology is minimally invasive and has much to offer in the renal transplant patient.
  
• Informed consent and an accurate appreciation of the complication rate is especially important when intervening on a renal transplant.
  
• Full monitoring with pulse oximetry, blood pressure and ECG should be mandatory when using conscious sedation.
  
• A combination of ultrasound and "C-arm" fluoroscopy is ideal for many procedures.
  

• Perirenal fluid collections are common and usually require no active management.
  
• Lymphocoeles are difficult to treat and may require sclerosis or surgical marsupialization.
  
• Transplant renal artery stenosis is common. Treatment if required is best served by an endovascular route (PTA/stent).
  
• Ureteric strictures are often due to ischaemia. Results of balloon dilatation and stenting are variable.
  
• Arteriovenous fistulae are common following renal biopsy. The majority close spontaneously.
  

• Interventional techniques for renal transplants

 • Biopsy

 • Drainage and sclerosis

 • Renal angioplasty and stenting

 • Nephrostomy

 • Ureteric dilatation and stenting

 • Embolisation

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