Diagnosis and Treatment of Early Transplant Renal Artery Stenosis: Experience From a Center in Eastern China

Qi, Ruochen; Qi, Guisheng; Zhu, Dong; Wang, Jina

doi:10.1016/j.transproceed.2019.11.021

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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Objective Endovascular treatment through either percutaneous transluminal angioplasty (PTA) alone or stenting has been previously used as a treatment for transplant renal artery stenosis (TRAS). This review aimed to investigate the results of endovascular treatment for renal artery stenosis in transplanted kidneys as compared with the outcomes of interventions, medical management, and graft survival in non-TRAS patients. Methods A systematic review of PubMed, Google Scholar, Cochrane, and Scopus was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in which studies that reported outcomes of the treatment of TRAS via the endoluminal approach were identified, and their results were meta-analyzed. Results Fifty-four studies with a total of 1522 patients were included. A significant reduction of serum creatinine level was found, favoring the stenting group, with a mean difference of 0.68 mg/dL (95% confidence interval (CI), 0.17–1.19; Z=2.60, p=0.0009). Comparison of pre- and post-intervention values of any intervention revealed a significant decrease in overall serum creatinine level (0.65 mg/dL; 95% CI, 0.40–0.90; Z=5.09, p=0.00001), overall blood pressure, with a mean difference of 11.12 mmHg (95% CI, 7.29–14.95; Z=5.59, p=0.00001), mean difference in the use of medications (0.77; 95% CI, 0.29–1.24; p=0.002), and peak systolic velocity (190.05; 95% CI, 128.41–251.69; p<0.00001). The comparison of serum creatinine level between endovascular interventions and best medical therapy favored endovascular intervention, with a mean difference of 0.23 mg/dL (95% CI, 0.14–0.32; Z=5.07, p<0.00001). Graft survival was similar between the treated patients and those without TRAS (hazard ratio, 0.98; 95% CI, 0.75–1.28; p=0.091). The overall pooled success rate was 89%, and the overall complication rate was 10.4%, with the most prevalent complication being arterial dissection. Conclusion The endovascular treatment of TRAS improves graft preservation and renal function and hemodynamic parameters. PTA + stenting appears to be a more effective option to PTA alone in the stabilization of renal function, with additional benefits from decreased restenosis rates. Further high-quality studies could expand on these findings.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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“…[8][9][10][11] It is a relatively frequent complication with an incidence between 1 and 23% and generally presents 3 to 24 months after transplant surgery. [12][13][14][15] If not treated, TRAS can lead to graft loss; therefore, early diagnosis is crucial to prompt management and successful treatment of complications. [16][17][18] Evaluating vascular patency of the graft is paramount in reducing dysfunction.…”

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confidence: 99%

Analysis of the Peak Systolic Velocity in the Transplant Renal Artery Anastomosis to Determine Normal Values in Patients Without Graft Dysfunction

Luna¹,

Hassan²,

Scortegagna³

et al. 2021

Journal of Diagnostic Medical Sonography

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Objective: The primary purpose is to define the mean renal artery anastomosis peak systolic velocity (RAA PSV) and the renal artery anastomosis to external iliac artery ratio (RAA-to-EIA) of renal transplant recipients without graft dysfunction. Moreover, to determine associations with type of vascular anastomosis and type of graft. Materials and Methods: This is a single-center retrospective analysis of kidney transplant recipients. Recorded variables included recipient age, type of vascular anastomosis, type of graft, RAA PSV, and external iliac artery PSV (EIA PSV). Such variables were evaluated on different postoperative follow-up periods. Results: There was a high degree of reliability between the RAA PSV and EIA PSV ( P < .001). The mean RAA PSV was 174 cm/s ± 72.9 cm/s with 95% confidence interval (CI) (162.2 cm/s-185.5 cm/s]. Conclusion: This study highlights the importance of determining the normal range of RAA PSV and showed that a high PSV does not necessarily indicate dysfunction.

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Assessment and Management of Transplant Renal Artery Stenosis. A Literature Review

Pini

Faggioli

Pini

et al. 2022

Annals of Vascular Surgery

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Diagnosis and Treatment of Early Transplant Renal Artery Stenosis: Experience From a Center in Eastern China

Cited by 5 publications

References 33 publications

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

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

Analysis of the Peak Systolic Velocity in the Transplant Renal Artery Anastomosis to Determine Normal Values in Patients Without Graft Dysfunction

Assessment and Management of Transplant Renal Artery Stenosis. A Literature Review

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