An unusual cause of post-biopsy oliguria in an allograft

Unusual cause of postrenal biopsy anuria in a renal transplant patient

Arteriovenous fistula (AVF) is an uncommon but well-known complication of percutaneous renal biopsy. Most postbiopsy AVFs are asymptomatic and regress spontaneously; however, some AVFs result in hypertension, hematuria and renal insufficiency. Transplant renal artery stenosis (TRAS) is a potentially curable cause of posttransplant arterial hypertension, allograft dysfunction and graft loss. Whether postbiopsy AVF superimposed on TRAS also regresses spontaneously is unknown. The authors present a case of acute renal failure in a 56-year-old male renal allograft recipient with the combination of postbiopsy AVF and TRAS. At first, the authors performed percutaneous angioplasty with stent implantation for the TRAS, but the AVF gradually enlarged. Eighteen months later, the patient began to experience hypertension, and his serum creatinine level increased; he received transcatheter arterial embolization therapy for enlarged AVF, and his renal function returned to baseline level.

Postbiopsy Arteriovenous Fistula in Renal Transplant: Two Cases of Spontaneous Resolution

Spontaneous outcomes of percutaneous biopsy-related arteriovenous fistulas in renal allografts instead of embolization are reported by describing two cases of postbiopsy arteriovenous fistula followed by color Doppler sonography (CDS). One patient developed gross hematuria, but no intervention was required. Doppler application showed spontaneous resolution in both cases but later in the patient with hematuria. Both cases support close observation, including CDS, as another alternative to early embolization.