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Renal transplant arterial thrombosis: association with cyclosporine
N Dodhia1, R A Rodby, S C Jensik
1Department of Medicine, Rush Medical College, Chicago, Il.
Insights
Renal transplant patients on cyclosporine A (CsA) experienced allograft arterial thrombosis (AAT) at a higher rate when multiple renal arteries (MRA) were present. MRA allografts had a 36% AAT incidence, compared to 0.8% for single renal artery allografts.
Area of Science:
- Nephrology
- Transplant Surgery
- Immunology
Background:
- Allograft arterial thrombosis (AAT) is a significant post-transplant complication.
- Understanding risk factors for AAT is crucial for improving renal transplant outcomes.
- Cyclosporine A (CsA) is a common immunosuppressant in renal transplantation.
Purpose of the Study:
- To investigate the incidence and risk factors of allograft arterial thrombosis (AAT) in renal transplant recipients.
- To evaluate the potential association between multiple renal arteries (MRA) and AAT in patients treated with CsA.
Main Methods:
- Retrospective analysis of 136 renal transplant patients between January 1984 and August 1988.
- All patients received prednisone and azathioprine, with CsA initiated post-transplant.
- Comparison of AAT incidence between allografts with single versus multiple renal arteries.
Main Results:
- Six cases (4.4%) of AAT occurred at a mean of 23 days post-transplantation.
- Five of six AAT episodes (83%) were in allografts with multiple renal arteries (MRA), an incidence of 36%.
- Only one of 122 single renal artery allografts (0.8%) experienced AAT; no correlation with CsA levels was found.
Conclusions:
- Allograft arterial thrombosis (AAT) is an early complication in renal transplants.
- Allografts with multiple renal arteries (MRA) have a significantly higher risk of AAT in patients treated with cyclosporine A (CsA).
- Careful surgical technique and patient selection may be warranted for MRA renal allografts in CsA-treated patients.
Abstract:
Of 136 patients who received a renal transplant between January 1984 and August 1988, there were six cases (4.4%) of allograft arterial thrombosis (AAT) occurring a mean of 23 days after transplantation. All were maintained on cyclosporine A(CsA) in addition to prednisone and azathioprine. All transplants were performed by the same transplant surgeon. Five of the six episodes (83%) were in allografts that had multiple renal arteries (MRA), giving an incidence of AAT in that group of 36%. Only one of 122 (0.8%) allografts with a single renal artery experienced thrombosis. CsA was started a mean of 9 days after transplantation (range, 16 to 33 days). There was no correlation of AAT to CsA levels. AAT appears to be an early complication of allografts with MRA in patients maintained on CsA.