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Case Reports in Nephrology
Volume 2015, Article ID 313610, 3 pages
http://dx.doi.org/10.1155/2015/313610
Case Report

Biopsy Induced Arteriovenous Fistula and Venous Stenosis in a Renal Transplant

1Tarrant Nephrology Associates, 1001 Pennsylvania Avenue, Fort Worth, TX 76104, USA
2Division of Transplant Nephrology, Fort Worth Transplant Institute, Plaza Medical Center, 900 Eighth Avenue, Fort Worth, TX 76104, USA
3Department of Interventional Radiology, Plaza Medical Center, 900 Eighth Avenue, Fort Worth, TX 76104, USA
4Division of Transplant Surgery, Fort Worth Transplant Institute, Plaza Medical Center, 900 Eighth Avenue, Fort Worth, TX 76104, USA

Received 13 June 2015; Accepted 16 August 2015

Academic Editor: Rumeyza Kazancioglu

Copyright © 2015 Sridhar R. Allam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Renal transplant vein stenosis is a rare cause of allograft dysfunction. Percutaneous stenting appears to be safe and effective treatment for this condition. A 56-year-old Caucasian female with end stage renal disease received a deceased donor renal transplant. After transplant, her serum creatinine improved to a nadir of 1.2 mg/dL. During the third posttransplant month, her serum creatinine increased to 2.2 mg/dL. Renal transplant biopsy showed BK nephropathy. Mycophenolate was discontinued. Over the next 2 months, her serum creatinine crept up to 6.2 mg/dL. BK viremia improved from 36464 copies/mL to 15398 copies/mL. A renal transplant ultrasound showed lower pole arteriovenous fistula and abnormal waveforms in the renal vein. Carbon dioxide (CO2) angiography demonstrated severe stenosis of the transplant renal vein. Successful coil occlusion of fistula was performed along with angioplasty and deployment of stent in the renal transplant vein. Serum creatinine improved to 1.5 mg/dL after.