Experience in Kidney Transplantectomy with Temporary Iliac Arterial Occlusion for Bleeding Control in Patients with High Cardiological Risk – A Case Report

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Diego Rodrigo Dametto
Eric Martinez Lino
Thiago da Silveira Antoniassi
Pedro Francisco Ferraz Arruda


Introduction: Approximately 16% of transplanted kidneys require surgical removal which may occur in cases of graft intolerance syndrome, premature loss, chronic inflammation, recurrent infections and cancer. When indicated, the classic technique is the open nephrectomy that may represent mortality rates at around 6 to 14%, reaching as high as 38% in cases of the procedure. The objective is to report a case of renal transplantectomy with intraoperative use of an iliac intravascular balloon catheter to control bleeding in a high-risk patient. The information was through reviewing the medical record, photographic record during the procedure and reviewing the literature.

Results: In this current case, the temporary occlusion of the iliac artery by a vascular balloon catheter proved to be effective in controlling bleeding during graft removal in a patient at high surgical risk.

Conclusions: Mortality related to transplantectomy is high, especially in cases of acute indication for the procedure and blood loss is an independent factor associated with increased morbidity and mortality and hospital stay. In this sense, the intraoperative use of a transient iliac intravascular balloon catheter in the reported case allowed for the control of bleeding during a graft nephrectomy in a high-risk surgical patient. Thus, there was a shortening of the surgical time, decreased need for transfusion, and safe anesthetic management, showing itself as an alternative in cases where surgical removal of the graft must be performed urgently.

Transplantectomy, transplants, graft nephrectomy, intravascular, temporary arterial occlusion.

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How to Cite
Dametto, D. R., Lino, E. M., Antoniassi, T. da S., & Arruda, P. F. F. (2020). Experience in Kidney Transplantectomy with Temporary Iliac Arterial Occlusion for Bleeding Control in Patients with High Cardiological Risk – A Case Report. Asian Journal of Research and Reports in Urology, 3(4), 18-22. Retrieved from http://journalajrru.com/index.php/AJRRU/article/view/30117
Case Study


Yeast C, Riley JM, Holyoak J, Ross Jr G, Weinstein S, Wakefield M. Use of preoperative embolization prior to transplant nephrectomy. International Brazilian Journal of Urology. 2016;42(1): 107-112.

Antón-Pérez G, Gallego-Samper R, Marrero-Robayna S, Henríquez-Palop F, Rodríguez-Pérez JC. Transplantectomy following renal graft failure. Nefrologia. 2012;32(5):573-578.

Takase HM, Contti MM, Nga HS, et al. Nephrectomy Versus Embolization of non-functioning renal graft: A systematic review with a proportional meta-analysis. Ann Transplant. 2018;23: 207-217.

González-Satué C, Riera L, Franco E, et al. Embolización percutánea del injerto renal afuncionante como alternativa terapéutica a la transplantectomía quirúrgica. Actas Urolológicas Españolas. 2000;24(4):319-324.

Pham PT, Everly M, Faravardeh A, et al. Management of patients with a failed kidney transplant: Dialysis reinitiation, immunosuppression weaning, and transplantectomy. World J Nephrol. 2015; 4:148–159.

Neschis DG, Gutta R, Al-Qudah HS, et al. Intraoperative coil embolization reduces transplant nephrectomy transfusion requirement. Vasc Endovascular Surg. 2007;41(4):335-338.

Larini P, Marcato C, Monaco D, et al. Percutaneous renal artery embolisation of non-functioning allograft. Preliminary experience. Radiol Med. 2005;110(5-6): 501-505.

Capocasale E, Larini P, Mazzoni MP, et al. Percutaneous renal artery embolization of nonfunctioning allograft: Preliminary experience. Transplant Proc. 2005;37(6): 2523-2524.

Al-Hadethi S, Fernando S, Hughes S, Thakorlal A, Seruga A, Scurry B. Does temporary bilateral balloon occlusion of the common iliac arteries reduce the need for intra-operative blood transfusion in cases of placenta accretism?. J Med Imaging Radiat Oncol. 2017;61(3):311-316.

Qiu Z, Hu J, Wu J, Chen L. Prophylactic temporary abdominal aorta balloon occlusion in women with placenta previa accretism during late gestation. Medicine (Baltimore). 2017;96(46):8681.