Renal Transplant Complications—A Pictorial Review

Renal transplantation is the most effective treatment for end-stage renal disease, with advanced immunosuppressive therapy and better surgical techniques resulting in better survival of the graft. Despite the advances, complications do occur in the postoperative period and timely diagnosis of the complications is vital for prompt management and salvage of the transplant. This pictorial essay aims to classify the complications of renal transplantation, describe the various imaging modalities used to detect complications, and provide a brief overview of the role of interventional radiology in their management. The complications can be broadly divided into perinephric fluid collections, vascular, collecting system, and parenchymal complications. Imaging including ultrasonography, computed tomography, magnetic resonance imaging, and newer methods like elastography, magnetic resonance imaging arterial spin labeling, diffusion-weighted imaging, diffusion kurtosis imaging, blood oxygenation-level dependent, and magnetic resonance elastography can be used in the diagnosis of these complications. Interventional radiology has advanced a lot in managing them; hence, interventional techniques can be the first choice of treatment in institutions where robust interventional radiology setup is available.