Embolization in Autosomal Polycystic Kidney Disease (APKD): An Adjunct to Transplantation

Introduction: Due to the large size of native kidneys in autosomal polycystic kidney disease (AKPD), a nephrectomy may be required prior to kidney transplantation to create space. As an alternative to nephrectomy, trans-arterial embolization (TAE) can be performed to achieve volume reduction.

Method(s): We report our experience of a UK tertiary center. Between 2017 and 2022, 20 TAEs on kidneys had been performed for volume reduction. Embolic agents included Boston Scientific PVA 45–150 µm particles and absolute ethanol. CT was performed preembolization and at 3 and 6 months to assess if required volume reduction was achieved. Renal volumes were calculated using the formula for an ellipsoid using the dimensions obtained on multiplanar CT by two interventional radiologists.

Result(s): A total of 20 procedures were performed on 15 patients. In total, 10/15 patients have been successfully transplanted. The mean volume pre-TAE was 2456 mL (range: 1,073–4,488 mL) and mean volume postembolization was 1,049 mL (range: 273–1649 mL), The mean percentage volume reduction achieved was 55.7%.

Conclusion(s): Initial results suggest that TAE is an alternative to nephrectomy in patients with AKPD.

Publication History

Article published online:
09 February 2023