[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
December 1984

Massive Hematuria Following Percutaneous Biopsy of Renal AllograftSuccessful Control by Selective Embolization

Author Affiliations

From the Departments of Surgery (Drs Horowitz, Kyriakides, and Miller), Radiology (Dr Russell), and Pediatrics (Dr Abitbol), University of Miami School of Medicine—Jackson Memorial Medical Center.

Arch Surg. 1984;119(12):1430-1433. doi:10.1001/archsurg.1984.01390240068012
Abstract

• We report on a patient who underwent a percutaneous needle biopsy of a renal allograft for evaluation of compromised function. Gross hematuria occurred immediately and persisted for three weeks, interrupted only by long intervals of anuria due to obstruction by a clot. The bleeding was controlled successfully by selective transcatheter embolization with a coil and an absorbable gelatin sponge (Gelfoam). The techniques and complications of allograft biopsy procedures are reviewed, and the management of hematuria occurring after a percutaneous needle biopsy is discussed. A percutaneous needle biopsy is the preferred method of sampling the transplanted kidney, with an adequate specimen obtained in 96% of cases. Hematuria, that has been reported to complicate 7% of percutaneous biopsy procedures, is usually transient, and only rarely is intervention required. Angiographically directed selective embolization is an effective technique for controlling massive or prolonged urinary hemorrhage after renal allograft biopsy.

(Arch Surg 1984;119:1430-1433)

References
1.
Pillay VKG, Kurtzman NA:  Percutaneous biopsy of the transplanted kidney . JAMA 1973;226:1561-1562.Article
2.
Buselmeier TJ, Schauer RM, Mauer SM, et al:  A simplified method of percutaneous allograft biopsy . Nephron 1976;16:318-321.Article
3.
Murphy GP:  Percutaneous needle biopsy of human renal allotransplants . J Urol 1972;107:193-195.
4.
Parker RA, Elliot WC, Muther RS, et al:  Percutaneous aspiration biopsy of renal allografts using ultrasound localization . Urology 1980;15: 534-535.Article
5.
Iversen P, Brun C:  Aspiration biopsy of the kidney . Am J Med 1951;11:324-330.Article
6.
Alwall N:  Aspiration biopsy of the kidney . Acta Med Scand 1952;143: 430-435.Article
7.
Slotkin EA, Madsen PO:  Complications of renal biopsy: Incidence in 5,000 reported cases . J Urol 1962;87:13-15.
8.
Leadbetter GW, Halverstadt DB:  Open renal biopsy . JAMA 1965;194: 1391-1392.Article
9.
Eiser AR, Vieux U, Neff MS, et al:  Angiographic visualization for percutaneous renal biopsy . Am J Kidney Dis 1983;3:129-132.Article
10.
Häyry P, von Willebrand E:  Transplant aspiration cytology in diagnostic evaluation of renal allografts . Transplant Proc 1981;13:1575-1578.
11.
Meng CH, Elkin M:  Immediate angiographic manifestations of iatrogenic renal injury due to percutaneous needle biopsy . Radiology 1971;100:335-341.Article
12.
O'Brien DP III, Parrott TS, Walton KN, et al:  Renal arteriovenous fistulas . Surg Gynecol Obstet 1974;139:739-743.
13.
Haygood TA, Atkins R, Kennedy JA, et al:  Aminocaproic acid treatment of prolonged hematuria following renal biopsy . Arch Intern Med 1971;127:478-481.Article
14.
Salcedo JR, Silverstein CE:  Postbiopsy bleeding in renal allograft: Successful treatment with epsilon aminocaproic acid . J Urol 1982;127:783.
15.
Coggins JT, Allen TD:  Insoluble fibrin clots within the urinary tract as a consequence of epsilon aminocaproic acid therapy . J Urol 1972;107; 647-649.
16.
White RI Jr:  Selected techniques in interventional radiology . JAMA 1981;245:741-744.Article
17.
Lussenhop AJ, Spence WT:  Artificial embolization of cerebral arteries: Report of use in a case of arteriovenous malformation . JAMA 1960;172:1153-1155.Article
18.
Bookstein JJ, Goldstein HM:  Successful management of postbiopsy arteriovenous fistula with selective arterial embolization . Radiology 1973;109:535-536.Article
19.
Farmer CD, Diaz-Buxo JA, Grubb WL, et al:  Control of postrenal biopsy hemorrhage by Gelfoam embolization . Nephron 1981;28:149-151.Article
20.
Neviackas JA, Bauer JH, Lee HT:  Selective renal artery embolization for control of biopsy-induced bleeding . South Med J 1981;74:69-71.Article
21.
Spigos DG, John EG, Chan L, et al:  Transcatheter control of renal hemorrhage following renal biopsy . J Pediatr Surg 1982;17:321-323.Article
22.
Hawkins IF, Garin EH:  Therapeutic renal embolization in children . J Pediatr 1979;93:415-417.Article
23.
Moreau JF, Merland JJ, Deschamps JM:  Postbiopsy false arterial aneurysm of a transplanted kidney: Treatment by bucrylate transcatheter embolization . J Urol 1982;128:116-118.
24.
Eckhauser ML, Haaga JR, Hampel N, et al:  Arterial embolization of renal allograft to control hemorrhage secondary to percutaneous nephropyelostomy . J Urol 1981;126:679-680.
25.
Marshall FF, White RI, Kaufman SL, et al:  Treatment of traumatic renal arteriovenous fistulas by detachable silicone balloon embolization . J Urol 1979;122:237-239.
26.
Bracken RB, Johnson DE, Goldstein HM, et al:  Percutaneous transfemoral renal artery occlusion in patients with renal carcinoma . Urology 1975;6:6-10.Article
×