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Risk Factors of Transplant Renal Artery Stenosis: A Meta-analysis
Pande Made Wisnu Tirtayasa1, Gerhard Reinaldi Situmorang2, Gede Wirya Kusuma Duarsa3
1Department of Urology, Faculty of Medicine, Universitas Udayana, Universitas Udayana Teaching Hospital, Bali, Indonesia.
Transplantation Proceedings
|September 19, 2025
Summary
Transplant renal artery stenosis (TRAS) is a common complication after kidney transplants. Key risk factors include multiple arteries, longer cold ischemia times, hypertension, diabetes, heart disease, and delayed graft function.
Area of Science:
- Nephrology
- Transplantation Surgery
- Vascular Surgery
Background:
- Transplant renal artery stenosis (TRAS) is a significant vascular complication following kidney transplantation, contributing to 75% of vascular events.
- TRAS can lead to severe post-transplant complications, including allograft dysfunction, graft loss, and hypertension.
Purpose of the Study:
- To evaluate the risk factors associated with transplant renal artery stenosis (TRAS) after kidney transplantation.
Main Methods:
- A comprehensive meta-analysis was conducted using data from Science Direct and PubMed databases.
- Included studies published up to January 2024 that assessed TRAS prevalence and risk factors in kidney transplant recipients.
Main Results:
- The meta-analysis identified 16 studies, encompassing 43,446 patients with 1465 cases of TRAS (3.37% incidence).
- Significant risk factors for TRAS include multiple allograft arteries, prolonged cold ischemia time, pre-existing hypertension, diabetes, ischemic heart disease, elevated systolic and diastolic blood pressure, delayed graft function, and acute rejection.
Conclusions:
- Several key variables are identified as significant risk factors for TRAS.
- Effective management of these identified risk factors is crucial for improving allograft function and long-term outcomes in kidney transplant recipients.
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