Acute Renal Failure in Kidney Transplantation Due to Subcapsular Hematoma After a Renal Allograft Biopsy: Report of Two Cases and Literature Review

Page kidney after pediatric kidney transplantation: a case report

“…The Page kidney (PK) entity has been recognized since the 1930s when Page first described this phenomenon in an experiment whereby he induced hypertension by wrapping a canine kidney with cellophane (5,(8)(9)(10)(11) . Since then, numer-ous case reports and small series have been described in the literature.…”

“…The majority of cases are iatrogenic and related to procedures or interventions performed on or surrounding the kidney. Kidney biopsy is the most frequent related intervention (1,5,8,9,12) . Bleeding around the kidney and subsequent hematoma following trauma or spontaneous may be the second most frequent origin.…”

“…Changes in parenchymal morphology and echogenicity close to the hematoma can be observed. Decreased peripheral and elevated resistive indexes in the arcuate arteries are invariable signs of PK (8,16) . Comparing images with previous US or with areas of non-compressed graft parenchyma might be beneficial in establishing diagnosis.…”

“…In selected cases of long standing perirenal collection, a fibrous carapace may develop and nephrectomy remains the only treatment option (13) . Naranjo et al conducted a literature review in order to describe the clinical characteristics and treatment of this infrequent complication (8) . In 33 out of 40 cases, capsulotomy with evacuation of the hematoma was the treatment of choice with a resolution rate of 77%.…”

“…Onset of hypertension shortly after the causative event constitutes the main symptom in patients without renal failure. However, in case of single native kidney or kidney transplant (KT), impaired renal function might be the first clinical manifestation (1,(5)(6)(7)(8) . Literature regarding PK in the pediatric transplant population remains scarce, with only two cases involving renal transplant biopsies reported (1) .…”