Massive Hematuria Following Percutaneous Biopsy of Renal Allograft: Successful Control by Selective Embolization

We report on a patient who underwent a percutaneous needle biospy of a renal allograft for evaluation of compromised function. Gross hematuria occurred immediately and persisted for those weeks, interrupted only by long intervals of anuria due to obstruction by a clot. The bleeding was controlled successfully by selective transcatheter embolization with a coil and an absorbable gelatin sponge (Gelfoam). The technique and complications of allograft biopsy procedures are reviewed, and the management of hematuria occurring after a percutaneous needle biopsy is discussed. A percutenous needle biospy is the preferred method of sampling the transplanted kidney, with an adequate specimen obtained in 96% of case. Hematuria, that has been reported to complicate 7% of percutaneous biopsy procedures, is usually transient, and only rarely is intervention required. Angiographically directed selective embolization is an effective technique for controlling massive or prolonged urinary hemorrhage after renal allograft biopsy.