Management of a postbiopsy arterial pseudoaneurysm in a transplanted kidney: Utilization of Epsilon aminocaproic acid and controlled hypotension

Percutaneous needle biopsy has been used widely as a diagnostic procedure for the evaluation of renal disease since its introduction by Iversen and Brun in 1951. This report describes a case of massive hematuria percutaneous needle biopsy of a renal allograft. Arteriographic study identified the source of bleeding as a pseudoaneurysm of an interlobar branch of the renal transplant artery. Treatment by induced controlled hypotension with Epsilon-amino-caproic acid (EACA) and nitroprusside resulted in early cessation of bleeding and improvement in renal function. Subsequent rupture of the pseudoaneurysm, however, necessitated an emergency nephrectomy.