The stuck haemodialysis catheter – a case report of a rare but dreaded complication following kidney transplantation

Background: Tunnelled cuffed haemodialysis catheters are at increased risk of incarceration, or ‘stuck’, via fibrotic adhesion to the central veins when left in situ for prolonged periods of time. Stuck catheters cannot be removed using standard techniques such as bedside dissection of the cuff. There are no published guidelines for this situation, and whilst several strategies have been published there is no consensus on the best approach. Here we present the first case of a stuck haemodialysis catheter in the acute post transplantation period. Case Presentation: A 66-year-old female on haemodialysis presented for kidney transplantation with a tunnelled-cuffed haemodialysis catheter in situ for five years. Following transplantation, removal of the line was unsuccessful despite dissection of the cuff, with traction causing a choking sensation with tracheal movement. Eventually, the line was removed without complications utilising sequential balloon dilatation in interventional radiology and the patient was discharged without complications. Conclusions This case serves as a timely reminder of the risks of long-term tunnelled haemodialysis catheters and as a caution towards proceeding with kidney transplantation in those with long-term haemodialysis catheters in situ . Greater nephrologist awareness of interventional radiology techniques for this challenging situation will help to avoid more invasive strategies.