Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (5): 928-931.doi: 10.3969/j.issn.1673-8225.2011.05.041

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Transplant renal artery stenosis in 10 cases

Zhang Gang, Fei Ji-guang, Chen Li-zhong, Wang Chang-xi, Qiu Jiang, Deng Su-xiong, Li Jun, Huang Gang   

  1. Second District, Department of Organ Transplantation, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou  510080, Guangdong Province, China
  • Received:2010-07-05 Revised:2010-09-03 Online:2011-01-29 Published:2011-01-29
  • Contact: Fei Ji-guang, Associate professor, Second District, Department of Organ Transplantation, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China feijg@126.com
  • About author:Zhang Gang☆, Studying for doctorate, Physician, Second District, Department of Organ Transplantation, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China 714140910@qq.com

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Abstract:

BACKGROUND: The embolization removal, anastomosing the vessels after resecting stenotic segment, or bridging the renal artery and iliac artery with self-vein, are used for the treatment of transplant renal artery stenosis (TRAS). Though the surgery skill is improving, some cases still suffered failure of renal functions.
OBJECTIVE: To investigate the causes, categorization, diagnosis, therapy and the curative effect of TRAS.
METHODS: The clinical data of 10 post renal transplant patients who got their final diagnosis of TRAS between 2002 and 2010 was retrospectively analyzed, including 8 males and 2 females, aged from 22 to 55 years, with a mean age of 36.9 years. The on set time of TRAS was from 5 days to 7.5 years after renal transplantation, while 8 occurred in 6 months after renal transplantation. The color Doppler ultrasonography was applied for screening. The digital subtraction arteriography was applied for diagnosis.
RESULTS AND CONCLUSION: Except for 2 patients (one rejected DSA, another underwent open operation), all the other 8 patients eventually underwent interventional therapy, and got their stenosis confirmed by arteriography. The degree of stenosis was 40%-80%, with a mean degree of 60.3%. Four patients underwent percutaneous transluminal angioplasty (PTA), the other 4 underwent percutaneous transluminal angioplasty and stent placement (PTAS). The curative effect of these 7 patients was perfect. 5 patients’ serum creatinine levels returned to normal, 2 patients’ dropped to the level before stenosis. Early after the interventional treatment, all the 7 patients got urinary volume increasing and a well control of the blood pressure. During the follow-up periods, none of those patients showed any signal of restenosis or thrombosis of the transplanted renal artery. One patient failed with the operation of PTA, and the transplanted kidney was removed. The results revealed that, for the patient with TRAS, the onset time, etiological factors and the degree of stenosis, should all be analyzed. We should make up a proper treatment program, in order to gain the best curative effect, and make the risk minimized meanwhile.

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