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Rate of Ipsilateral Chronic Limb-Threatening Ischemia (CLTI) After Kidney Transplantation: A Retrospective

Abdul Kader Natour1, Ziad Al Adas1, Timothy Nypaver1

  • 1Vascular Surgery, Henry Ford Health System, Detroit, USA.

Cureus
|July 1, 2022
PubMed

Insights

Kidney transplant recipients requiring lower extremity (LE) intervention showed a higher risk of ipsilateral LE arterial insufficiency. This suggests a link between transplant side and subsequent vascular complications.

Area of Science:

  • Vascular Surgery
  • Transplant Surgery
  • Nephrology

Background:

  • Kidney transplantation is a life-saving procedure.
  • Peripheral arterial disease (PAD) is a common complication in transplant recipients.
  • The potential association between kidney transplant side and ipsilateral lower extremity (LE) ischemia is not well understood.

Purpose of the Study:

  • To investigate if kidney transplant recipients have a higher rate of lower extremity (LE) ischemia on the side ipsilateral to the transplanted kidney.
  • To analyze the risk of peripheral arterial disease (PAD) complications necessitating intervention after kidney transplantation.

Main Methods:

  • Retrospective query of an institutional transplant database (January 2004 - July 2020).
  • Inclusion of patients who received a kidney transplant and underwent subsequent LE revascularization or major limb amputations.
  • One-sample binomial test used to assess the risk of ipsilateral LE vascular complications.

Main Results:

  • Out of 1,964 kidney transplant recipients, 51 (3%) experienced subsequent LE interventions.
  • A significantly higher number of ipsilateral LE vascular interventions (33) compared to contralateral (18) occurred (P = 0.049).
  • The average interval between transplantation and intervention was 52 months for ipsilateral and 41 months for contralateral interventions (P = 0.33).

Conclusions:

  • An association exists between the side of kidney transplantation and the risk of future ipsilateral LE arterial insufficiency in patients requiring surgical intervention.
  • Further research is warranted to elucidate the underlying causes of this observed association.
  • This finding highlights a potential area for increased surveillance and targeted interventions in kidney transplant recipients.
Abstract

Keywords:
chronic limb threatening ischemiaend-stage renal diseasekidney transplantationlower extremity revascularizationperipheral artery disease

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