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Changes in venous hemodynamics after renal transplantation
J W Merkus1, W B Barendregt, W N van Asten
1Department of Surgery, University Hospital St Radboud, Nijmegen, The Netherlands. jws.merkus@inter.nl.net
Summary
Transient leg swelling in kidney transplant patients is linked to increased venous outflow resistance. This temporary condition resolves within six weeks post-transplant, suggesting it
Area of Science:
- Nephrology
- Vascular Surgery
- Transplant Medicine
Background:
- Renal transplant recipients occasionally experience transient ipsilateral leg swelling.
- Deep vein thrombosis is typically absent in these cases.
- The underlying cause of this swelling requires investigation.
Purpose of the Study:
- To investigate the cause of transient leg swelling in renal transplant recipients.
- To measure venous outflow resistance and assess for thrombosis in both legs.
- To correlate findings with the renal transplantation procedure.
Main Methods:
- Serial strain gauge plethysmography and duplex examinations were performed on 14 renal transplant recipients.
- Measurements were taken before transplantation and at 1 and 6 weeks post-transplantation.
- Venous outflow resistance, venous flow, and presence of thrombosis were assessed.
Main Results:
- A significant increase in venous outflow resistance was observed in the ipsilateral leg 1 week post-transplantation (P < 0.05).
- Venous outflow resistance returned to baseline by 6 weeks post-transplantation.
- Duplex examinations revealed no signs of deep vein thrombosis, and venous flow measurements were not significantly different.
Conclusions:
- Increased venous outflow resistance in the ipsilateral leg following renal transplantation can explain transient swelling.
- This finding may influence diagnostic approaches for venous thrombosis in transplant patients.
- The additional blood supply to iliac veins appears to be the causative factor.