Living Donor Transplantation of Kidneys with Fibromuscular Dysplasia: Indications, Surgical Techniques and Long Term Results in 11 Cases

Berardinelli, L

doi:10.4172/2161-0959.s4-008

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Fibromuscular dysplasia (FMD) has a reported incidence of 4.4% in prospective renal donors, and it is the second most common cause of renovascular hypertension after atherosclerotic disease 19 . The presence of fibromuscular dysplasia is not a contra‐indication to transplant 20 . Typically, if FMD is identified unilaterally that kidney would be chosen for transplant.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of renal vascular anatomy on multi‐detector computed tomography in living renal donors

et al. 2020

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Background: Prospective renal donors are a select population of healthy individuals who have been thoroughly screened for significant comorbidities before they undergo multi-detector computed tomography angiography and urography (MDCT). Purpose: The aim of this study is to describe the anatomy of potential living renal donor subjects using MDCT over a 2-year period. The primary objective is to identify the renal arterial anatomy variations, with a secondary objective of identifying venous and collecting system/ureteric variations. Materials and Methods: A prospective study was performed of prospective living kidney transplant donors at a national kidney transplant centre. Study inclusion criteria were all potential kidney donors who underwent MDCT during the living-donor assessment process over a 2-year period. Results: Our cohort included 160 potential living donors who had MDCT; mean age was 45.6 years (range, 21-71). Two renal arteries were identified on the left in 40 subjects (25%) and on the right in 42 subjects (26.3%). A total of 3 or more renal arteries were identified on the left in 7 subjects (4.4%) and on the right in 7 subjects (4.4%). On the left, the distances between multiple arteries ranged from 1 mm to 43 mm, and on the right, they were 1 mm to 84 mm. Conclusions: Conventionally described anatomy was only seen on the left side in 70.6% and 69.4% on the right side of subjects. Single renal arteries are seen in 54.4% showing that conventional anatomy has a relatively low incidence.

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Section: Discussionmentioning

confidence: 99%

“…19 The presence of fibromuscular dysplasia is not a contra-indication to transplant. 20 Typically, if FMD is identified unilaterally that kidney would be chosen for transplant. Our cohort had one such case.…”

Section: Discussionmentioning

confidence: 99%

Assessment of renal vascular anatomy on multi‐detector computed tomography in living renal donors

et al. 2020

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Preoperative Imaging Evaluation of Living Kidney Transplant Donors

Helmy

Troppmann

Fananapazir

2018

Transplantation Imaging

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Undiagnosed fibromuscular dysplasia in a deceased donor kidney transplant successfully treated with angioplasty

2020

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A 41-year-old man with end-stage renal disease received a deceased donor kidney transplant without complication. Maintenance immunosuppression consisted of tacrolimus, mycophenolate and prednisone. Two months after transplantation, his creatinine did not improve beyond 2–2.3 mg/dL, which prompted allograft biopsy. His biopsy showed tubular epithelial injury without rejection, and given concern for possible calcineurin-inhibitor toxicity, his tacrolimus was changed to sirolimus. Renal function improved, but 1 month later he presented to the hospital with seizure activity, severe hypertension, acute kidney injury and MRI findings suggestive of posterior reversible encephalopathy syndrome. Blood pressure was difficult to control, which had not been the case in the immediate posttransplant period, and addition of lisinopril worsened his renal function. Transplant renal artery stenosis was suspected, and allograft ultrasound with doppler confirmed our suspicion. The patient underwent an angiogram, showing 60% stenosis of the mid-distal transplanted renal artery. Interventional radiology successfully stented this lesion, with subsequent improvement in allograft function and blood pressure control. He did not require further intervention in follow-up.

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Living Donor Transplantation of Kidneys with Fibromuscular Dysplasia: Indications, Surgical Techniques and Long Term Results in 11 Cases

Cited by 3 publications

References 20 publications

Assessment of renal vascular anatomy on multi‐detector computed tomography in living renal donors

Assessment of renal vascular anatomy on multi‐detector computed tomography in living renal donors

Preoperative Imaging Evaluation of Living Kidney Transplant Donors

Undiagnosed fibromuscular dysplasia in a deceased donor kidney transplant successfully treated with angioplasty

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