The Impact of Renal Transplantation on Lower Limb Perfusion

Alexander, Paul

doi:10.23937/2572-4045.1510013

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…In a normal LE arterial system, autoregulation ensures that distal blood flow is not significantly compromised. However, this might not be fully possible in patients with PAD, which might lead to supply-demand imbalance and subsequent ischemia to the legs [ 27 , 28 ]. Few studies have explored this “blood steal” phenomenon.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have explored this “blood steal” phenomenon. A small pilot study of 18 patients measured postoperative blood flow in the ipsilateral and contralateral legs after kidney transplantation and showed no significant difference between the two legs [ 28 ]. This study, however, was limited by its small sample size, measurement of blood flow at rest, and having had only one patient with a confirmed PAD diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Rate of Ipsilateral Chronic Limb-Threatening Ischemia (CLTI) After Kidney Transplantation: A Retrospective Single-Center Study

Natour¹,

Adas²,

Nypaver³

et al. 2022

Cureus

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Objective: To analyze whether the rate of lower extremity (LE) ischemia is higher on the ipsilateral side after kidney transplantation. Methods: Our institutional transplant database was retrospectively queried for all patients who received a kidney transplant and underwent subsequent LE revascularization or major limb amputations between January 2004 and July 2020. The one-sample binomial test was used to test whether the LE ipsilateral to the transplanted kidney was at higher risk of peripheral arterial disease (PAD) complications necessitating intervention (major amputation or revascularization). Results: There were 1,964 patients who received a kidney transplant during the study period. Of these, 51 patients (3%) had subsequent LE arterial revascularizations or major amputations. The mean age was 58 ± 10 years, and 37 patients (73%) were male. A total of 33 patients had ipsilateral LE vascular interventions (26 major amputations and seven revascularizations) while 18 patients had contralateral vascular interventions (14 major amputations and four revascularizations) (P = 0.049). The average interval between transplantation and subsequent vascular intervention was 52 months for the ipsilateral intervention group and 41 months for the contralateral intervention group (P = 0.33). Conclusions: In patients who received kidney transplantation and required subsequent LE surgical intervention, we observed an association between the side of transplantation and the risk of future ipsilateral LE arterial insufficiency. Further studies are needed to determine the etiology of this association.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%