Effectiveness Of Percutaneous Embolization As Treatment Compared To Nephrectomy For Renal Graft Intolerance Syndrome In Late Graft Failure Patients
Department of Vascular and Transplant Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea, Republic of
Meeting: 2019 American Transplant Congress
Abstract number: 294
Keywords: Graft failure, Kidney transplantation, Nephrectomy, Surgical complications
Session Information
Session Name: Concurrent Session: Surgical Issues: All Organs
Session Type: Concurrent Session
Date: Monday, June 3, 2019
Session Time: 2:30pm-4:00pm
Presentation Time: 3:42pm-3:54pm
Location: Room 208
*Purpose: Failed renal allografts left in situ may cause inflammation presenting as graft intolerance syndrome (GIS). But there is no standardization for treatment of a non-functioning renal graft. Renal graft percutaneous embolization could avoid the risk associated with surgical removal in most late graft failure patients presenting a GIS. In this study, we evaluate the efficacy of embolization on the resolution of GIS and compares the two techniques, graft nephrectomy and embolization
*Methods: Among patients required dialysis after 1 year of transplantation, we retrospectively reviewed the data of patients diagnosed as only GIS with symptomatic graft like pain, hematuria or fever and treated with nephrectomy or embolization in the period between 2006 and 2018. All of them has undertaken kidney transplantation in a single center.
*Results: A total of 38 patients were included (22 patients in transplanetomy and 16 in embolization). Mean age were 48.0 ± 10.28 ( in nephrectomy group) and 46.69 ± 12.08 years old ( in embolization group). the two groups were similar concerning sex, manifestations of GIS. Mean time from graft failure to the procedure was shorter in embolization group (26 months) compared to nephrectomy group (85 months). In procedural related factors like mean procure time, hospital stay, ICU stay, blood loss and needs of transfusion , it showed better results in embolization group(Table 1), significantly. Only one patient had complication, puncture site hematoma after embolization. 2 patients had removal site hematoma and one patient experienced post operation ileus in nephrectomy. There was no mortality case related with procedures. 10 of 22 (45.5%) in nephrectomy group underwent percutaneous embolization 1 day before surgical removal. In pre-embolization patients, they had shorter procedure time, less blood loss and shorter hospital stays compared with patients undertaken surgical removal directly without pre-embolization.$$ table1
*Conclusions: Embolization of symptomatic failed renal grafts wound has considerable efficacy and saftey with less morbidity and no serious complication compared to graft nephrectomy and pre-embolization before nephrectomy can be the effective suggestion to reduce the risk related to operation.
| Nephrectomy(n=22) | Embolization(n=16) | p-value | |
| Number of patients | 22 | 16 | |
| Age, years | 48.0 ± 10.28 | 46.69 ± 12.08 | 0.720 |
| Mean time from KT to graft failure , months | 181.6 ± 174.2 | 197.3 ± 172.6 | 0.786 |
| Mean time from Graft failure to procedure, months | 85.3 ± 145.0 | 26.1 ± 32.5 | 0.077 |
To cite this abstract in AMA style:
Kwon S, Go J, Park S, Yoon S, Kim J, Moon I. Effectiveness Of Percutaneous Embolization As Treatment Compared To Nephrectomy For Renal Graft Intolerance Syndrome In Late Graft Failure Patients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/effectiveness-of-percutaneous-embolization-as-treatment-compared-to-nephrectomy-for-renal-graft-intolerance-syndrome-in-late-graft-failure-patients/. Accessed November 21, 2024.« Back to 2019 American Transplant Congress