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Abstract

Objectives: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis. Materials and Methods: During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomog raphy reconstruction and were treated with endo vascular approaches or medically managed. Results: Ten patients were diagnosed with transplant renal artery stenosis by 3-dimensional computed tomography reconstruction. No evidence of contrastinduced nephrotoxicity was observed. Nine of the 10 patients underwent percutaneous transluminal angio plasty, whereas the remaining patient was treated conservatively. Procedural success rate was 100%. Patients were followed for a mean period of 20 ± 3 months. Blood pressure improved from a mean of 163/90 to 132/73 mm Hg at the end of the follow-up period. In the 9 patients who underwent angioplasty, serum creatinine improved from 198 ± 24 to 134 ± 16 µmol/L at the end of the follow-up period. The cystatin C level in some patients declined after interventional therapy. Conclusions: Three-dimensional computed tomography reconstruction is a safe choice for patients who present with increased serum creatinine levels and refractory hypertension. Percutaneous transluminal angioplasty is the preferred therapeutic technique for transplant renal artery stenosis.

Endovascular Treatment of Transplant Renal Artery Stenosis: A Systematic Review and Meta-analysis

“…Only 35 studies provided enough data for meta-analysis. An overall summary of the included studies, size, and evidence grading can be found in Supplemental Table S1 2,4,7,12,27-77 . We propose a diagnostic and therapeutic algorithm that reflects the findings, which is displayed in Figure 2 on the basis of the frequency of reporting cutoff parameters.…”

Spontaneous recanalization of occluded transplant renal artery: a rare case report

“…Computed tomographic angiography (CTA) has a high spatial resolution, and its three-dimensional post-processing function can directly display the stenosis site and enables evaluation of the degree of stenosis and the condition of adjacent tissues from multiple angles. Moreover, with the use of non-ionic contrast agents, CTA damage to renal function is also significantly reduced [ 7 ]. Magnetic resonance angiography (MRA) is often used in patients with severe renal dysfunction.…”

“…It has high sensitivity and specificity, and the contrast agent is not toxic to the kidney [ 8 ]. However, it has been shown that MRA tends to overestimate the extent of stenosis [ 7 ]. Digital subtraction angiography (DSA) is still considered the gold standard for TRAS diagnosis and can be used for endovascular treatment [ 2 ].…”