These authors have contributed equally to this publication.
Acute Page Kidney Following Renal Allograft Biopsy: A Complication Requiring Early Recognition and Treatment
Article first published online: 29 APR 2008
© 2008 The Authors Journal compilation © 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 8, Issue 6, pages 1323–1328, June 2008
How to Cite
Chung, J., Caumartin, Y., Warren, J. and Luke, P. P. W. (2008), Acute Page Kidney Following Renal Allograft Biopsy: A Complication Requiring Early Recognition and Treatment. American Journal of Transplantation, 8: 1323–1328. doi: 10.1111/j.1600-6143.2008.02215.x
- Issue published online: 30 MAY 2008
- Article first published online: 29 APR 2008
- Received 21 December 2007, revised 17 February 2008 and accepted for publication 21 February 2008
- kidney transplant
The acute Page kidney phenomenon occurs as a consequence of external compression of the renal parenchyma leading to renal ischemia and hypertension. Between January 2000 and September 2007, 550 kidney transplants and 518 ultrasound-guided kidney biopsies were performed. During that time, four recipients developed acute oligo-anuria following ultrasound-guided allograft biopsy. Emergent doppler-ultrasounds were performed demonstrating absence of diastolic flow as well as a sub-capsular hematoma of the kidney. Prompt surgical exploration with allograft capsulotomy was performed in all cases. Immediately after capsulotomy, intraoperative Doppler study demonstrated robust return of diastolic flow. Three patients maintained good graft function, and one kidney was lost due to acute antibody-mediated rejection. We conclude that postbiopsy anuria associated with a subcapsular hematoma and acute absence of diastolic flow on doppler ultrasound should be considered pathognomonic of APK. All renal transplant specialists should be able to recognize this complication, because immediate surgical decompression can salvage the allograft.