The significance of ipsilateral leg ischaemia after renal transplantation

Area of Science:

• Vascular Surgery
• Nephrology
• Transplant Medicine

Background:

• Renal transplant recipients can develop arterial complications affecting ipsilateral leg perfusion.
• Iliac stenosis is a potential vascular complication that may impact renal allograft function.

Observation:

• Three male renal transplant patients (50-57 years) presented with leg ischemia on the transplant side.
• Two patients had proximal iliac stenosis treated with percutaneous transluminal angioplasty.
• One patient with external iliac artery occlusion underwent femoro-femoral bypass grafting, later requiring angioplasty for internal iliac stenosis.

Findings:

• Percutaneous transluminal angioplasty and bypass grafting are effective treatments for iliac stenosis in renal transplant patients.
• Iliac stenosis, particularly proximal to the transplant kidney, poses a significant risk to graft survival.
• Long-term follow-up revealed a case of internal iliac stenosis occurring 17 years post-transplantation.

Implications:

• Urgent investigation of leg ischemia symptoms in renal transplant recipients is essential.
• Early diagnosis and management of iliac stenosis can prevent graft loss.
• Vigilance for vascular complications is critical throughout the post-transplant period, even years after the procedure.