J Korean Soc Transplant.  2011 Sep;25(3):190-195. 10.4285/jkstn.2011.25.3.190.

Successful Renal Transplantation in Patients with Polycystic Kidneys after Renal Contraction by Renal Artery Embolization: Report on 2 Cases

• Park UJ
• Kim HT
• Kim MY
• Hwang EA
• Han SY
• Park SB
• Kim HC
• Kim YH
• Cho WH

• KMID: 1450968
• DOI: http://doi.org/10.4285/jkstn.2011.25.3.190

Abstract

Autosomal polycystic kidney disease is responsible for about 10% of the cases of end stage renal disease. The increase in kidney size is usually proportional to the degree of deterioration in renal function. At the time of transplantation, these nonfunctional kidneys can be massively enlarged and nephrectomy is required before renal transplantation. However, pretransplantation nephrectomy of polycystic kidneys has the potential risk of surgical complications, including ileus, hernias, infection, excessive bleeding and/or intestinal injury. We report here on two cases successful renal transplantation in patients with polycystic kidneys after renal contraction by renal artery embolization and without nephrectomy. The volume reduction was evaluated by CT before and 3 months after renal artery embolization and the reduction in volume was 48% and 44% in each case, respectively. The embolization was well tolerated in both cases without immediate or delayed complications except for fever and lumbar flank pain. Four months after renal artery embolization, both of the patients successfully received a transplant from living donors.

Keyword

ADPKD; Renal artery embolization; Renal transplantation

MeSH Terms

Contracts
Fever
Flank Pain
Hemorrhage
Hernia
Humans
Ileus
Kidney
Kidney Failure, Chronic
Kidney Transplantation
Living Donors
Nephrectomy
Polycystic Kidney Diseases
Polycystic Kidney, Autosomal Dominant
Renal Artery
Transplants

Figure

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  Fig. 1. Case 1. (A) Initial abdominal CT shows enlarged kidneys with multiple cysts. (B) Follow-up abdominal CT taken 3 months after right renal artery embolization shows markedly decreased size of the right kidney. (C) Selective angiography of the right renal artery reveals a typical polycystic kidney vascular bed. (D) Coil embolization of renal artery induce stagnant flow without the filling of intrarenal branches and complete obstruction of the two renal artery.

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  Fig. 2. Case 2. (A) Initial abdominal CT shows enlarged kidneys with multiple cysts. (B) Follow-up abdominal CT taken 3 months after right renal artery embolization shows markedly decreased size of the right kidney. (C) Selective angiography of the right renal artery. (D) Coil embolization of renal artery.

Reference

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