Gelatin-thrombin hemostatic matrix injection to salvage refractory post-renal graft biopsy bleed

V Jain¹, A Gupta¹, A Gulia¹, M Singhal², S Gulati³, SC Tiwari³, A Kumar^1 
1 Department of Urology, Robotics and Renal Transplant, Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, India
² Department of Nephrology, Fortis Hospital, Noida, Uttar Pradesh, India
³ Department of Nephrology, Robotics and Renal Transplant, Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, India

Correspondence Address:
A Kumar
Department of Urology, Robotics and Renal Transplant, Fortis Flt. Lt. Rajan Dhall Hospital, Sector B, Pocket 1, Aruna Asaf Ali Road, New Delhi - 110 070
India

Post-renal biopsy bleeding refractory to angioembolization usually requires graft nephrectomy as a life-saving measure. Gelatin-thrombin hemostatic matrix injection in the needle tract is a novel attempt to control bleeding in such cases and to salvage the allograft. We hereby describe two cases of post-graft biopsy bleed. Both these patients continued to bleed even after angioembolization. They were shifted to the operating room upon developing hypotension, having received multiple blood transfusions with the intention of performing graft nephrectomy to save their lives. However, bleeding was successfully controlled by using Gelatin-thrombin hemostatic matrix injection in the biopsy needle tract. Patients improved hemodynamically after the procedure. Graft function returned to normal in both the cases. At an average follow-up of 10.4 months, both the patients have shown stable graft functions.