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Transplant renal artery stenosis
J P Roberts1, N L Ascher, D S Fryd
1Department of Radiology, University of Minnesota, Minneapolis.
Transplantation
|October 1, 1989
Summary
Surgical repair of renal artery stenosis after kidney transplant is more effective than angioplasty. Angioplasty often fails, leading to graft loss, while surgery offers better outcomes for transplant recipients.
Area of Science:
- Nephrology
- Transplantation Surgery
- Vascular Surgery
Background:
- Renal artery stenosis (RAS) is a complication following kidney transplantation.
- Anastomotic site stenosis is the most common form of RAS in transplant patients.
Purpose of the Study:
- To compare the efficacy of angioplasty versus surgical repair for treating anastomotic renal artery stenosis in kidney transplant recipients.
- To identify factors influencing the success of interventions for transplant RAS.
Main Methods:
- Retrospective analysis of 31 patients with transplant RAS identified from 2002 renal transplant recipients.
- Comparison of outcomes between 25 angioplasty procedures and 18 surgical repairs.
- Evaluation of failure modes, including recurrent stenosis and arterial injury.
Main Results:
- Angioplasty for anastomotic stenosis yielded poor results in 20 of 25 procedures (failure rate of 80%).
- Surgical repair was performed 18 times, resulting in cure or improvement for 13 patients with no graft loss.
- Failures of angioplasty were often due to recurrent stenosis or arterial injury leading to graft loss or requiring emergency surgery.
Conclusions:
- Angioplasty for anastomotic renal artery stenosis in kidney transplant recipients is associated with a high failure rate and poor outcomes.
- Surgical repair appears to be a more effective and safer treatment option, offering better success rates and preserving graft function.
- Patients without significant physiological evidence of RAS may not experience improvement in hypertension post-intervention.