Percutaneous embolization of the failed renal allograft in patients with graft intolerance syndrome

Objective To analyse the circumstances, results and complications of percut aneous embolization in failed renal grafts that are not tolerated, to avoid surgical graft removal in selected patients. Patients and methods The study included 33 patients (mean age 42 years, SD 13.9) whose renal grafts failed between 1990 and 1999. The patients underwe nt percutaneous embolization of their renal transplant for graft intoleranc e syndrome. The allograft was left in situ after failure for a mean (SD) of 9.9 (6.5) months. The subsequent hospital stay, the appearance of complica tions and the final results were assessed. Results Post-embolization syndrome (fever for 2-5 days) appeared in 20 (61% ) of the patients; the clinical intolerance resolved in 28 (85%). The embol ization was unsuccessful in five of the 33 patients (15%) and they required graft removal. The mean (SD) hospital stay was 5 (2) days; there were no m ajor complications from graft embolization. Conclusions Graft embolization avoids kidney removal in many patients with failed and rejected transplants, with low rates of morbidity. Surgical graf t nephrectomy was useful when graft intolerance syndrome persisted after em bolization.