Persistent hematuria postkidney transplant due to needle biopsy at the time of kidney retrieval: Successful management with selective renal artery embolization

Persistent hematuria following kidney transplantation is an uncommon yet potentially serious complication with a wide differential, including vascular injury from biopsy procedures performed either before or after implantation. We present a case of persistent hematuria in a kidney transplant recipient, ultimately traced to a pseudoaneurysm resulting from a needle biopsy performed during donor kidney retrieval. Despite initial conservative measures, bleeding persisted and required selective renal artery embolization (RAE), which resulted in complete resolution and preservation of graft function. This report underscores the importance of early recognition, targeted imaging, and timely intervention in preventing graft loss and optimizing patient outcomes.