Anastomotic Pseudoaneurysm in Post Renal Transplantation

Abstract

Renal arterial pseudoaneurysm is a rare complication of renal transplantation that often causes a graft loss. Approximately 10% of patients undergoing renal transplantation may suffer a medical, urological or a vascular complication. The existence of very small series of patients with pseudoaneurysm after renal transplantation and isolated case reports published in current literature indicates it is rare. Controversy persists in eliciting the etiology, occurrence, indications for repair, treatment options and prognosis. Imaging plays a major role and so that inspire us to present our modest experience with pseudoaneurysm after renal transplant. Pseudoaneurysm can be easily detected by Ultrasonography and color Doppler. The analysis of literature and from our series leads us to formulate some considerations: The anastomotic pseudoaneurysm should be identified early, this condition can be fulfilled only with periodic ultrasound monitoring in post-transplant follow up. Conservative procedures should be considered in patients in good condition with preserved graft function and without symptoms or signs of infection. Open surgical repair, endovascular repair and ultrasound guided percutaneous thrombin injection are the current reported treatment options. Pseudoaneurysm can carry a potentially devastating loss of allograft and the need for allograft nephrectomy. Early diagnosis and timely operation might be the most important factors in the survival of patients. Clinical, biochemical as well as radiological follow up examination confirmed successful therapeutic management of the patient.