Combined percutaneous mechanical and chemical thrombectomy for renal vein thrombosis in kidney transplant recipients.

Renal vein thrombosis occurring after the immediate post-transplant period often leads to loss of the transplant organ. We report two cases of renal vein thrombosis in the setting of de novo membranous nephropathy occurring 5 and 26 months post-transplantation. Both cases were treated with percutaneous mechanical thrombectomy and localized catheter-directed thrombolysis with resolution of clot burden, and regained kidney function after thrombolysis without subsequent thromboses. Percutaneous mechanical thrombolysis can be safely done in renal transplant recipients and should be considered in patients with renal vein thrombosis beyond the immediate post-operative period in order to minimize exposure to systemic thrombolysis.