Routine ureteric stenting is unnecessary in kidney transplantation in patients at low risk for urological complications. Careful surgical technique with selective stenting of problematic anastomoses yields similar results.

RAPA conversion provides adequate immunosuppression to enable CsA withdrawal. However, when converting patients to RAPA drug levels should be monitored to avoid over-immunosuppression and adequate antiviral and Pneumocystis carinii pneumonia prophylaxis should be given.

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Objective To analyse the circumstances, results and complications of percutaneous embolization in failed renal grafts that are not tolerated, to avoid surgical graft removal in selected patients. Patients and methods The study included 33 patients (mean age 42 years, SD 13.9) whose renal grafts failed between 1990 and 1999. The patients underwent percutaneous embolization of their renal transplant for graft intolerance syndrome. The allograft was left in situ after failure for a mean (SD) of 9.9 (6.5) months. The subsequent hospital stay, the appearance of complications and the ®nal results were assessed. Results Post-embolization syndrome (fever for 2±5 days) appeared in 20 (61%) of the patients; the clinical intolerance resolved in 28 (85%). The embolization was unsuccessful in ®ve of the 33 patients (15%) and they required graft removal. The mean (SD) hospital stay was 5 (2) days; there were no major complications from graft embolization. Conclusions Graft embolization avoids kidney removal in many patients with failed and rejected transplants, with low rates of morbidity. Surgical graft nephrectomy was useful when graft intolerance syndrome persisted after embolization.

These results demonstrated that kidney transplantation along with a better quality of life for patients are a cost-saving decision for developing countries.

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