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Successful Control by Selective Embolization

Michael D. Horowitz, MD; Edward Russell, MD; Carolyn Abitbol, MD; George Kyriakides, MD; Joshua Miller, MD

Arch Surg. 1984;119(12):1430-1433.

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)

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.

Footnotes
Accepted for publication July 26, 1984.

Reprint requests to Division of Transplantation, Department of Surgery, University of Miami School of Medicine, PO Box 016310, Miami, FL 33101 (Dr Miller).

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