[Arterial complications after renal transplantation]

Area of Science:

• Vascular Surgery
• Nephrology
• Transplantation Medicine

Context:

• Arterial complications are a significant concern following renal transplantation, impacting graft survival and patient health.
• These complications can manifest clinically or be detected during routine post-transplant surveillance.
• Management strategies are crucial for addressing diverse arterial lesions in this patient population.

Purpose:

• To review the surgical experience and outcomes of treating arterial complications in renal transplant recipients.
• To analyze the types of arterial lesions encountered and the surgical techniques employed.
• To evaluate the short-term and long-term results of surgical interventions for these complications.

Summary:

• This study details the surgical management of 154 patients with arterial complications post-renal transplantation between 1970 and 2003.
• Lesions included mycotic and atherosclerotic aneurysms, aortic/iliac obstructions, and transplant artery stenoses, with surgical repair tailored to the specific complication.
• No postoperative deaths occurred; three graft losses resulted from transplant artery reconstruction thrombosis (2.4%).

Impact:

• Surgical intervention for arterial complications after renal transplantation demonstrates favorable short-term outcomes with no operative mortality.
• Long-term surveillance is essential to manage potential complications such as recurrent stenosis, graft aneurysm formation, and progression of atherosclerotic disease.
• While surgical success is high, late graft loss due to chronic rejection and cardiovascular mortality in atherosclerotic patients remain critical considerations.