A kink in transplantation: a rare cause of early graft dysfunction

Kink of the transplant renal artery is a rare yet correctable cause of early graft dysfunction. We describe a 35-year-old male patient with end-stage renal disease who underwent live, related renal transplantation with end-to-side anastomosis of the graft vessels with the external iliac vessels. He had oliguria and uncontrolled hypertension in the post-operative course and was found to have a parvus tardus waveform on Doppler ultrasound and an acute angled kink of the renal artery on angiography. After failure of initial attempts at per cutaneous transluminal renal angioplasty, the patient was re-explored and the graft renal artery was anastomosed with the internal iliac artery. The patient had a steady recovery and was discharged with a good renal function. A kinking of the renal artery should be excluded when early graft dysfunction is associated with a parvus tardus waveform.