Standards of reporting for interventional radiology treatment of renal and pancreatic transplantation complications.

INTRODUCTION During the past three decades, the number of renal transplantations for curative therapy of chronic renal insufficiency has more than quadrupled, with pancreatic transplantation being increasingly used as definitive treatment for diabetes mellitus (1–3). As diabetes mellitus frequently contributes to renal failure, combined (synchronous or metachronous) renal and pancreatic transplantations are commonly performed. Consequently, renal and pancreatic transplantation-related interventions have become important to interventional radiology. Transplant graft procedures have to be separated from interventions to the native kidney and pancreas (including native visceral vessels) because differences relevant for percutaneous interventions go far beyond those of renal, pancreatic, and visceral vascular anatomy. Unlike interventions to native kidneys, renal and pancreatic transplant graft interventions largely involve treatment of complications that occur in chronically immunocompromised patients and—as will be discussed later—are typically related to the initial renal transplantation surgery. Interventions are typically subdivided into treatment of vascular and nonvascular complications. Vascular complications include transplant and iliac artery stenoses, arterial injury (eg, arterial transection, dissection, or pseudoaneurysm formation), lower gastrointestinal bleeding (specific to pancreatic transplants), arteriovenous and arteriocalyceal fistula formation (specific to renal transplants), and renal and pancreatic graft artery and venous thromboses. Typical examples of nonvascular complications are obstructive uropathy/nephropathy, urine leak, perigraft fluid collections such as lymphocele, abscess and urinoma formation, as well as graft rejection (4,5). For pancreatic transplantation, most nonvascular complications, with the exception of perigraft collections, are not treated by interventional radiologic means, and, for the sake of document size, will not be discussed in this document. Regardless of the type of intervention that is being considered, an effort should be made to address relevant patient comorbidities, such as