{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:22:59Z","timestamp":1792135379241,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>After graft failure, kidney transplant recipients may develop immunological intolerance to the allograft left in situ. In such cases, surgical removal of the allograft is usually performed, but is associated with substantial morbidity and mortality. A less invasive option is percutaneous embolization of the renal artery. Here, we describe our clinical experience with embolization and report observed differences with graft nephrectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, single\u2010center study, we included kidney transplant recipients who underwent either graft nephrectomy or embolization between 2018 and 2024. Patients with indication \u201cgain of space\u201d were excluded. We reported on major post\u2010procedural complications within three months (Clavien Dindo score 3\u20134), post\u2010embolization syndrome, blood transfusions, length of hospitalization and readmissions, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 13 embolizations and 32 graft nephrectomies. Major post\u2010procedural complications occurred in 23% after embolization versus 41% after nephrectomy (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.32). Length of hospitalization was shorter after embolization compared to nephrectomy (median 1 vs. 5 days,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001). Post\u2010embolization syndrome occurred in 9 of 13 patients (69%) and was managed conservatively. One patient with recent graft infections required a subsequent nephrectomy for infected necrosis after embolization. Another patient with residual blood flow after embolization required a nephrectomy for persisting hematuria. Two patients with pre\u2010existing sepsis and bacteriemia died after embolization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Embolization results in shorter length of hospitalization and is likely associated with a reduced incidence\u00a0of procedure\u2010related major complications as compared to nephrectomy. Pre\u2010existing sepsis is a risk factor for adverse outcomes after embolization, and recent graft infections should be considered a contra\u2010indication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70542","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T17:34:19Z","timestamp":1777052059000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Graft Embolization versus Nephrectomy in Patients with Graft Intolerance and Infection: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9481-4537","authenticated-orcid":false,"given":"Matthe\u00fcs F.","family":"Klaassen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"Otterspeer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelon","family":"van Agteren","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6700-188X","authenticated-orcid":false,"given":"Sebastiaan","family":"Heidt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8536-2083","authenticated-orcid":false,"given":"Diederik","family":"Kimenai","sequence":"additional","affiliation":[{"name":"Division of HPB and Transplant Surgery, Department of Surgery Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0578-6316","authenticated-orcid":false,"given":"Kay J.","family":"Pieterman","sequence":"additional","affiliation":[{"name":"Department of Radiology University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9494-3717","authenticated-orcid":false,"given":"Robert C.","family":"Minnee","sequence":"additional","affiliation":[{"name":"Division of HPB and Transplant Surgery, Department of Surgery Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-2025","authenticated-orcid":false,"given":"Annelies E.","family":"de Weerd","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2014530"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneph.2024.1223114"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399\u20100012.2001.150606.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.12659\/AOT.883887"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000050658.94353.24"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.04.024"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2018.08.001"},{"issue":"9","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"2494","DOI":"10.1097\/01.ASN.0000137879.97445.6E","article-title":"Presence of a Failed Kidney Transplant in Patients Who Are on Hemodialysis Is Associated With Chronic Inflammatory state and Erythropoietin Resistance","volume":"15","author":"L\u00f3pez\u2010G\u00f3mez J. 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