Long-term Outcomes after Transplant Renal Artery Stenosis Surgery

Rouer, Martin; Godier, Sylvie; Monnot, Antoine; Étienne, Isabelle; Bertrand, Dominique; Guerrot, Dominique; Plissonnier, Didier

doi:10.1016/j.avsg.2018.05.066

Cited by 6 publications

(6 citation statements)

References 34 publications

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“…Generally, surgical revascularization is reserved for cases of unsuccessful angioplasty. Long-term renal allograft function and survival with a mean follow-up of 9.8 ± 2.1 years has demonstrated the efficacy and safety of surgical revascularization (108).…”

Section: Transplant Renal Artery Stenosis (Tras)mentioning

confidence: 99%

Approach and Management of Hypertension After Kidney Transplantation

Tantisattamo

Molnár

et al. 2020

Front. Med.

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Section: Transplant Renal Artery Stenosis (Tras)mentioning

confidence: 99%

Approach and Management of Hypertension After Kidney Transplantation

Tantisattamo

Molnár

et al. 2020

Front. Med.

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“…Only 35 studies provided enough data for meta-analysis. An overall summary of the included studies, size, and evidence grading can be found in Supplemental Table S1 2,4,7,12,27-77 . We propose a diagnostic and therapeutic algorithm that reflects the findings, which is displayed in Figure 2 on the basis of the frequency of reporting cutoff parameters.…”

Section: Resultsmentioning

confidence: 99%

Endovascular Treatment of Transplant Renal Artery Stenosis: A Systematic Review and Meta-analysis

et al. 2021

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Objective Endovascular treatment through either percutaneous transluminal angioplasty (PTA) alone or stenting has been previously used as a treatment for transplant renal artery stenosis (TRAS). This review aimed to investigate the results of endovascular treatment for renal artery stenosis in transplanted kidneys as compared with the outcomes of interventions, medical management, and graft survival in non-TRAS patients. Methods A systematic review of PubMed, Google Scholar, Cochrane, and Scopus was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in which studies that reported outcomes of the treatment of TRAS via the endoluminal approach were identified, and their results were meta-analyzed. Results Fifty-four studies with a total of 1522 patients were included. A significant reduction of serum creatinine level was found, favoring the stenting group, with a mean difference of 0.68 mg/dL (95% confidence interval (CI), 0.17–1.19; Z=2.60, p=0.0009). Comparison of pre- and post-intervention values of any intervention revealed a significant decrease in overall serum creatinine level (0.65 mg/dL; 95% CI, 0.40–0.90; Z=5.09, p=0.00001), overall blood pressure, with a mean difference of 11.12 mmHg (95% CI, 7.29–14.95; Z=5.59, p=0.00001), mean difference in the use of medications (0.77; 95% CI, 0.29–1.24; p=0.002), and peak systolic velocity (190.05; 95% CI, 128.41–251.69; p<0.00001). The comparison of serum creatinine level between endovascular interventions and best medical therapy favored endovascular intervention, with a mean difference of 0.23 mg/dL (95% CI, 0.14–0.32; Z=5.07, p<0.00001). Graft survival was similar between the treated patients and those without TRAS (hazard ratio, 0.98; 95% CI, 0.75–1.28; p=0.091). The overall pooled success rate was 89%, and the overall complication rate was 10.4%, with the most prevalent complication being arterial dissection. Conclusion The endovascular treatment of TRAS improves graft preservation and renal function and hemodynamic parameters. PTA + stenting appears to be a more effective option to PTA alone in the stabilization of renal function, with additional benefits from decreased restenosis rates. Further high-quality studies could expand on these findings.

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“…The prevalence of transplant RAS ranges from 1% to 23% depending on the definition. 89 , 90 Transplant RAS is associated with a decrease in 5-year allograft survival rate (79% vs 89% in transplant recipients without transplant RAS), supporting the use of renal artery revascularization in these patients. Endovascular treatment of transplant RAS is usually very effective and seldom requires stent placement.…”

Section: Management Of Arvd In Special Populationsmentioning

confidence: 98%

“…91 Surgical revascularization is currently limited to TRAS not amenable to angioplasty or following failure of endovascular treatment. 90 Heart failure ARVD is highly prevalent in HF, occurring in 34% of acute hospitalizations with systolic HF in patients aged >70 years 92 and in 54% of HF outpatients with CKD. 3 Some of the earliest case series describing response to revascularization in ARVD noted significant diuresis and J o u r n a l P r e -p r o o f improvement in echocardiographic parameters among HF patients.…”

Section: Kidney Transplant Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Atherosclerotic Renovascular Disease: A KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference

Hicks

Clark

Cooper

et al. 2022

American Journal of Kidney Diseases

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Long-term Outcomes after Transplant Renal Artery Stenosis Surgery

Cited by 6 publications

References 34 publications

Approach and Management of Hypertension After Kidney Transplantation

Approach and Management of Hypertension After Kidney Transplantation

Endovascular Treatment of Transplant Renal Artery Stenosis: A Systematic Review and Meta-analysis

Atherosclerotic Renovascular Disease: A KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference

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