Renal Artery Stenosis in Transplanted Kidney:
Management and Results in Six Patients

Serrallach, N; Serrate, R; Franco, Eduardo; Naranjo, Javier; Aguiló, F; Gutiérrez, R; Rius, G; Montañá, Xavier; Marco-Luque, Miguel A.; Ma, Cairols

doi:10.1159/000472445

Cited by 5 publications

(5 citation statements)

References 11 publications

(16 reference statements)

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“…The incidence of renal artery stenosis is more common in cadavaric transplants, and it appears that a long cold ischemic time may predispose the transplant to renal artery stenosis. [37][38][39] The etiology of the stenosis appears to be multifactorial and may be secondary to intimal hyperplasia, immune related proliferation, ischemic injury, and cytomegalovirus (CMV) arteritis. 39,40 Pouria et al 40 have implicated that CMV may induce large vessel renal damage through local infection and mitogenic effects of viral gene products.…”

Section: Vascular Complicationsmentioning

confidence: 99%

“…[37][38][39] The etiology of the stenosis appears to be multifactorial and may be secondary to intimal hyperplasia, immune related proliferation, ischemic injury, and cytomegalovirus (CMV) arteritis. 39,40 Pouria et al 40 have implicated that CMV may induce large vessel renal damage through local infection and mitogenic effects of viral gene products. In long-standing transplants, progression of underlying atherosclerosis in the recipient iliac artery can also be a source of arterial narrowing.…”

Section: Vascular Complicationsmentioning

confidence: 99%

“…Endovascular management is the initial treatment of choice for transplant renal artery stenosis. [29][30][31]36,37,39 However, if the narrowing is detected within the first 4 weeks after the initial transplantation, endovascular therapy should be approached with extreme caution because of the significant risk of disrupting the surgical anastomosis with balloon angioplasty or stent intervention. There are multiple series in the literature evaluating percutaneous transluminal angioplasty (PTA) and the treatment of transplant renal artery stenosis ( Table 3).…”

Section: Vascular Complicationsmentioning

confidence: 99%

“…4). [28][29][30][31][32][34][35][36][37][38][39] Serum creatinine levels usually return to baseline in 3 to 5 days if PTA is technically successful.…”

Section: Vascular Complicationsmentioning

confidence: 99%

“…Serious complications are uncommon (1.5 to 8%) and are usually related to puncture site complications; however, arterial rupture, dissection, and thrombosis have been reported. [28][29][30][31][32][33][34][35][36][37][38][39] The loss of the graft has been rare. Improvement in hypertension management has occurred in 60 to 70% of patients after PTA.…”

Section: Vascular Complicationsmentioning

confidence: 99%

See 4 more Smart Citations

Interventional Radiological Management of the Complications of Renal Transplantation

Johnson¹,

Berry²

2001

Semin intervent Radiol

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Section: Vascular Complicationsmentioning

confidence: 99%

Section: Vascular Complicationsmentioning

confidence: 99%

Section: Vascular Complicationsmentioning

confidence: 99%

“…4). [28][29][30][31][32][34][35][36][37][38][39] Serum creatinine levels usually return to baseline in 3 to 5 days if PTA is technically successful.…”

Section: Vascular Complicationsmentioning

confidence: 99%

Section: Vascular Complicationsmentioning

confidence: 99%

See 3 more Smart Citations

Interventional Radiological Management of the Complications of Renal Transplantation

Johnson¹,

Berry²

2001

Semin intervent Radiol

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Transplant renal artery stenosis: experience and comparative results between surgery and angioplasty

et al. 1990

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One hundred thirty-eight patients with transplant renal artery stenosis (TRAS) were identified among 1200 patients undergoing renal transplantation in our university hospital. Severe systemic hypertension was the main symptom leading to a diagnosis of TRAS. Only 88 TRAS patients were given interventional treatment consisting of percutaneous angioplasty (PTA; n = 49) or surgical repair (SR; n = 39). The immediate success rate was 92.1% for SR and 69% for PTA. The long-term success rate was 81.5% for SR and 40.8% for PTA, with a follow-up period of 56.7 +/- 22.4 months (SR group) and 32 +/- 28.1 months (PTA group). PTA morbidity reached 28%, compared to 7.6% in the SR group. In spite of these results, we still favor PTA as a first line interventional treatment when TRAS is recent, linear, and distal and primary SR in cases of kinking and proximal TRAS.

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Renal artery stenosis in pediatric transplant recipients

et al. 1987

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From 1967 through 1985, 400 cadaveric transplants were performed at Children Hospital of Los Angeles. Of these 400, 31 were later identified as having renal artery stenosis. No live related graft developed RAS. Of the 31 grafts, 11 were from donors less than 2 years of age. The major feature suggesting stenosis was hypertension; either persistent or a sudden exacerbation often associated with hypertensive encephalopathy. In individuals with hypertension without obvious cause, renal angiography should be promptly conducted under controlled conditions to avoid complications. The stenotic lesion involved 13 end-to-end and 19 end-to-side arterial anastomoses. Surgery for revascularization of RAS was performed in 21 of 31 with success or improvement in 14, no change in 2, and graft loss in 5. Percutaneous transluminal angioplasty was performed in 4. Two were unsuccessful, 1 was successful and 1 graft was lost. The 7 remaining patients were treated medically.

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Renal Artery Stenosis in Transplanted Kidney: Management and Results in Six Patients

Cited by 5 publications

References 11 publications

Interventional Radiological Management of the Complications of Renal Transplantation

Interventional Radiological Management of the Complications of Renal Transplantation

Transplant renal artery stenosis: experience and comparative results between surgery and angioplasty

Renal artery stenosis in pediatric transplant recipients

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