Contrast-Enhanced Ultrasound Reveals Masked Post-Baseline Wedge Transplant Biopsy Pseudoaneurysm

Abstract

Biopsy of the transplanted kidney is known to cause intraparenchymal renal vascular injury. The most common vascular complications include arteriovenous fistula (AVF) and pseudoaneurysm (PA). We report a case of a patient who underwent cadaveric renal transplantation and developed an AVF and a PA after an on-table wedge biopsy. The PA was missed during the standard Doppler sonographic examination because of its small size but was unmasked with the use of contrast-enhanced ultrasound (CEUS). Fourteen days after the first CEUS, the procedure was repeated and showed complete thrombosis of the PA.