Rofo 2023; 195(06): 495-504
DOI: 10.1055/a-2007-9649
Review

Interventional Management of Vascular Complications after Renal Transplantation

Article in several languages: English | deutsch
Niklas Verloh
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
,
Michael Doppler
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
,
Muhammad Taha Hagar
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
,
Charlotte Kulka
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
,
Ricarda von Krüchten
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
,
Jakob Neubauer
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
,
Jakob Weiß
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
,
Elvira Röthele
2   Department of Medicine IV, Medical Center-University of Freiburg, Germany
,
Johanna Schneider
2   Department of Medicine IV, Medical Center-University of Freiburg, Germany
,
Bernd Jänigen
3   Department of General and Visceral Surgery, Medical Center-University of Freiburg, Germany
,
1   Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
› Author Affiliations

Abstract

Background Kidney transplantations are increasing due to demographic changes and are the treatment of choice for end-stage renal disease. Non-vascular and vascular complications may occur in the early phase after transplantation and at later stages. Overall postoperative complications after renal transplantations occur in approximately 12 % to 25 % of renal transplant patients. In these cases, minimally invasive therapeutic interventions are essential to ensure long-term graft function. This review article focuses on the most critical vascular complications after renal transplantation and highlights current recommendations for interventional treatment.

Method A literature search was performed in PubMed using the search terms “kidney transplantation”, “complications”, and “interventional treatment”. Furthermore, the 2022 annual report of the German Foundation for Organ Donation and the EAU guidelines for kidney transplantation (European Association of Urology) were considered.

Results and Conclusion Image-guided interventional techniques are favorable compared with surgical revision and should be used primarily for the treatment of vascular complications. The most common vascular complications after renal transplantation are arterial stenoses (3 %–12.5 %), followed by arterial and venous thromboses (0.1 %–8.2 %) and dissection (0.1 %). Less frequently, arteriovenous fistulas or pseudoaneurysms occur. In these cases, minimally invasive interventions show a low complication rate and good technical and clinical results. Diagnosis, treatment, and follow-up should be performed in an interdisciplinary approach at highly specialized centers to ensure the preservation of graft function. Surgical revision should be considered only after exhausting minimally invasive therapeutic strategies.

Key Points:

  • Vascular complications after renal transplantation occur in 3 % to 15 % of patients.

  • Image-guided interventional procedures should be performed primarily to treat vascular complications of renal transplantation.

  • Minimally invasive interventions have a low complication rate with good technical and clinical outcomes.

Citation Format

  • Verloh N, Doppler M, Hagar MT et al. Interventional Management of Vascular Complications after Renal Transplantation. Fortschr Röntgenstr 2023; 195: 495 – 504



Publication History

Received: 19 July 2022

Accepted: 28 November 2022

Article published online:
02 March 2023

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