Semin intervent Radiol 2004; 21(4): 239-246
DOI: 10.1055/s-2004-861558
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Interventional Management of Renal Transplant Arteriovenous Fistula

Jeanne M. LaBerge1
  • 1Department of Radiology, Division of Interventional Radiology, University of California, San Francisco
Further Information

Publication History

Publication Date:
07 January 2005 (online)


Percutaneous needle biopsy has become an indispensable tool for the evaluation and management of patients with renal allograft dysfunction. But this invasive procedure is not without risk. Vascular injury in the form of arteriovenous fistula, pseudoaneurysm, or arteriocalyceal fistula may result in symptoms that require percutaneous endovascular intervention. In this article, the occurrence, detection, and treatment of biopsy-related renal transplant injury are described.


  • 1 Baxter G M. Imaging in renal transplantation.  Ultrasound Q. 2003;  19 123-138
  • 2 Chandraker A. Diagnostic techniques in the work-up of renal allograft dysfunction-an update.  Curr Opin Nephrol Hypertens. 1999;  8 723-728
  • 3 Chan R, Common A A, Marcuzzi D. Ultrasound-guided renal biopsy: experience using an automated core biopsy system.  Can Assoc Radiol J. 2000;  51 107-113
  • 4 Omoloja A A, Racadio J M, McEnery P T. Post-biopsy renal arteriovenous fistula.  Pediatr Transplant. 2002;  6 82-85
  • 5 Martinez T, Palomares M, Bravo J A et al.. Biopsy-induced arteriovenous fistula and venous aneurysm in a renal transplant.  Nephrol Dial Transplant. 1998;  13 2937-2939
  • 6 Naraghi R M, Jordan M L. Surgical complications. In: Shapiro R, Simmons RL, Starzl TE Renal Transplantation Stamford, CT; Appleton & Lange 1997: 269-298
  • 7 Furness P N, Philpott C M, Chorbadjian M T et al.. Protocol biopsy of the stable renal transplant: a multicenter study of methods and complication rates.  Transplantation. 2003;  76 969-973
  • 8 Merkus J W, Zeebregts C J, Hoitsma A J, van Asten W N, Koene R A, Skotnicki S H. High incidence of arteriovenous fistula after biopsy of kidney allografts.  Br J Surg. 1993;  80 310-312
  • 9 Lawen J G, van Buren C T, Lewis R M, Kahan B D. Arteriovenous fistulas after renal allograft biopsy: a serious complication in patients beyond one year.  Clin Transplantation. 1990;  4 357-369
  • 10 Middleton W D, Kellman G M, Melson G L, Madrazo B L. Postbiopsy renal transplant arteriovenous fistulas: color Doppler US characteristics.  Radiology. 1989;  171 253-257
  • 11 Claudon M, Lefevre F, Hestin D, Martin-Bertaux A, Hubert J, Kessler M. Power Doppler imaging: evaluation of vascular complications after renal transplantation.  AJR Am J Roentgenol. 1999;  173 41-46
  • 12 Brandenburg V M, Frank R D, Riehl J. Color-coded duplex sonography study of arteriovenous fistulae and pseudoaneurysms complicating percutaneous renal allograft biopsy.  Clin Nephrol. 2002;  58 398-404
  • 13 Mohaupt M G, Perrig M, Vogt B. 3D Ultrasound imaging-a useful non-invasive tool to detect AV fistulas in transplanted kidneys.  Nephrol Dial Transplant. 1999;  14 940-943
  • 14 Bagga H, Bis K G. Contrast-enhanced MR angiography in the assessment of arteriovenous fistula after renal transplant biopsy.  AJR Am J Roentgenol. 1999;  172 1509-1511
  • 15 Spinosa D J, Pao D G, Matsumoto A H, Hagspiel K D, Angle J F, Hooper T N. Carbon dioxide and gadodiamide as the contrast agents for diagnosis and embolization of a post-biopsy arteriovenous fistula in a renal allograft.  Clin Radiol. 2000;  55 801-803
  • 16 deSouza N M, Reidy J F, Koffman C G. Arteriovenous fistulas complicating biopsy of renal allografts: treatment with superselective embolization.  AJR Am J Roentgenol. 1991;  156 507-510
  • 17 Shimmura H, Ishikawa N, Tanabe K et al.. Angiographic embolization in patients with renal allograft arteriovenous fistula.  Transplant Proc. 1998;  30 2990-2992
  • 18 Dorffner R, Thurnher S, Prokesch R et al.. Embolization of iatrogenic vascular injuries of renal transplants: immediate and follow-up results.  Cardiovasc Intervent Radiol. 1998;  21 129-134
  • 19 Perini S, Gordon R L, LaBerge J M et al.. Transcatheter embolization of biopsy-related vascular injury in the transplant kidney: immediate and long-term outcome.  J Vasc Interv Radiol. 1998;  9 1011-1019
  • 20 Kitajima K, Fuchinoue S, Koyama I et al.. Embolization for arteriovenous fistula after graft biopsy in renal transplant recipients: is it essential for all cases?. Transplant Proc 2000 32: 1911
  • 21 Maleux G, Messiaen T, Stockx L, Vanrenterghem Y, Wilms G. Transcatheter embolization of biopsy-related vascular injuries in renal allografts. Long-term technical, clinical and biochemical results.  Acta Radiol. 2003;  44 13-17
  • 22 Bilge I, Rozanes I, Acunas B et al.. Endovascular treatment of arteriovenous fistulas complicating percutaneous renal biopsy in three paediatric cases.  Nephrol Dial Transplant. 1999;  14 2726-2730
  • 23 Nakatani T, Uchida J, Han Y S et al.. Renal allograft arteriovenous fistula and large pseudoaneurysm.  Clin Transplant. 2003;  17 9-12

Jeanne M LaBergeM.D. 

Department of Radiology, Division of Interventional Radiology, University of California, San Francisco

505 Parnassus Avenue, M-361, Box 0628

San Francisco, CA 94143