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Clinical and Experimental Nephrology

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01-10-2020 | Kidney Transplantation | Original article

Arteriovenous fistulas after ultrasound-guided needle biopsy of kidney allografts and treatment outcomes after transcatheter embolization: A single-center experience in Japan

Authors: Kiyomi Osako, Masahiko Yazawa, Maho Terashita, Naohiko Imai, Ryuto Nakazawa, Hideo Sasaki, Yugo Shibagaki

Published in: Clinical and Experimental Nephrology | Issue 10/2020

Abstract

Background

Arteriovenous fistula (AVF) is one of the vascular complications after allograft biopsy, and their reported incidence rates range widely. Transcatheter embolization (TE) is a common AVF treatment in kidney allografts. However, information on AVF incidence and features and TE outcomes in Japanese kidney transplant (KT) recipients is lacking.

Methods

This study investigated 270 protocol or clinically indicated kidney allograft biopsies in 129 KT recipients during 2010–2016 at a single-center using standardized methods (16-gauge needle and ultrasound guidance). We recorded the incidence and clinical features of AVF using currently recommended standardized methods of allograft biopsy and TE outcomes regarding allograft function up to 12 months after the procedure in Japanese KT recipients.

Results

AVF incidence was 2.6% (seven cases). The time from biopsy to AVF diagnosis was 7 (median, interquartile range: 5–117, range: 1–318) days. The time from biopsy to AVF diagnosis was significantly shorter in symptomatic cases (gross hematuria) than in asymptomatic cases (median 6 vs. 117 days, p = 0.034). Symptomatic patients underwent TE within a shorter time (0–6 days) than asymptomatic patients (25–104 days). There were no complications, and allograft function was stable up to 12 months after TE despite using contrast media and partial renal infarction.

Conclusions

AVF does occur in certain probabilities. AVF formation can occur without apparent bleeding and exist for a long time after allograft biopsy. TE is a safe and immediate treatment for AVF in kidney allograft.

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Title: Arteriovenous fistulas after ultrasound-guided needle biopsy of kidney allografts and treatment outcomes after transcatheter embolization: A single-center experience in Japan
Authors: Kiyomi Osako
Masahiko Yazawa
Maho Terashita
Naohiko Imai
Ryuto Nakazawa
Hideo Sasaki
Yugo Shibagaki
Publication date: 01-10-2020
Publisher: Springer Singapore
Keywords: Kidney Transplantation
Ultrasound
Kidney Transplantation
Kidney Transplantation
Arteriovenous Fistula
Hematuria
Ultrasound
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Renal Infarction
Arteriovenous Fistula
Published in: Clinical and Experimental Nephrology / Issue 10/2020
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI: https://doi.org/10.1007/s10157-020-01922-8

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Abstract

Background

Methods

Results

Conclusions

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