Subcapsular haematoma: a cause of post biopsy oliguria in renal allografts

Reversible acute anuric kidney injury after surgical evacuation of perinephric hematomas as a complication of renal transplant biopsies

“…It has become safer with the introduction of ultrasound guidance resulting in a reduction in complications. However, complications do occur putting the renal allograft at risk, and immediate action is necessary in these cases to prevent renal allograft loss .…”

“…In 1939, Page first described the development of hypertension and impaired renal function due to compression of renal parenchyma in animal models. More recently, this phenomenon, in relation to transplanted kidneys, has become known as RACS . In some cases where there is difficulty in piercing the thickened capsule of “old” renal allografts (which is not uncommon for renal biopsy operators), the capsule may be particularly difficult to penetrate because of the post‐transplant wound infection and dehiscence that the patient experiences .…”

“…More recently, this phenomenon, in relation to transplanted kidneys, has become known as RACS . In some cases where there is difficulty in piercing the thickened capsule of “old” renal allografts (which is not uncommon for renal biopsy operators), the capsule may be particularly difficult to penetrate because of the post‐transplant wound infection and dehiscence that the patient experiences . Subsequently, the post‐biopsy hemorrhage is contained within the thickened perinephric capsule leading to compressed parenchyma and rapid deterioration in renal allograft function.…”

“…Subcapsular hematoma should be high on the list of differential diagnoses when there is an unusual degree of pain, oliguria, and rapid deterioration in renal allograft function after biopsy . It is important for radiologists to be aware of this complication and its varied radiological appearances.…”

Subcapsular Hematoma Evacuation as a Method of Evaluating Injured Kidneys for Transplant

“…4,8,9 These subcapsular hematomas have resulted from renal allograft trauma or posttransplant biopsy. [10][11][12][13][14] The evacuation of a subcapsular hema toma has been used as the method of treatment to prevent renal failure. [10][11][12][13] A significant percentage of organ donors in the United States have resulted from trauma fatalities (in 2006, 35.47%; in 2005, 34.70%).…”