Successful endoluminal thrombo-aspiration of renal graft venous thrombosis

Renal transplant vein thrombosis is an unusual event occuring in 0.3-3 % of renal transplantations. Prognosis is uniformly poor with graft loss in nea rly every case. We report here the first three cases of renal graft vein th rombosis successfully treated by percutaneous endoluminal thromboaspiration . After an initially uneventful course all recipients developed anuria and required hemodialysis. In two cases, an ultrasound examination suggested a diagnosis of venous thrombosis, Emergency arteriography and phlebography we re performed, confirming the complete thrombosis of the graft veins. Thromb oaspiration was carried out with full heparinization and led to renal funct ion improvement in all cases. Grafts are still functioning 6 months after t he procedure, with serum creatinine levels of 176 mu mol/l, 120 mu mol/l an d 184 mu mol/l, respectively. Thus, this procedure avoids surgical and anae sthetic risks and allows, if performed at an early stage, restoration of gr aft function. Great care must be taken to avoid vein wall damage, vascular suture line rupture, or pulmonary embolism.