C. Calzas Montalvo , J. Medina-Polo , N.R. Miranda Utrera , S. Juste Álvarez , A. de la Calle Moreno , M.P. Caro González , R. Santos Perez de la Blanca , M. Hernández Arroyo , E. Peña Vallejo , J. Teigell Tobar , J.M. Duarte Ojeda , M. Pamplona Casamayor , Á. Tejido Sánchez , L. García González , A. Arrébola Pajares , Á. Sánchez Guerrero , J. Rodríguez de la Calle , A. Rodríguez Antolín
{"title":"Transplant renal artery stenosis: Study of incidence using doppler ultrasound, risk factors and analysis is effect in graft outcomes","authors":"C. Calzas Montalvo , J. Medina-Polo , N.R. Miranda Utrera , S. Juste Álvarez , A. de la Calle Moreno , M.P. Caro González , R. Santos Perez de la Blanca , M. Hernández Arroyo , E. Peña Vallejo , J. Teigell Tobar , J.M. Duarte Ojeda , M. Pamplona Casamayor , Á. Tejido Sánchez , L. García González , A. Arrébola Pajares , Á. Sánchez Guerrero , J. Rodríguez de la Calle , A. Rodríguez Antolín","doi":"10.1016/j.acuroe.2023.08.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and objectives</h3><p><span>Transplant renal artery stenosis<span> (TRAS) is a vascular complication after kidney transplantation which estimated incidence is 13%. It could cause refractory arterial hypertension, </span></span>kidney dysfunction and premature death in transplant recipients.</p></div><div><h3>Methods</h3><p><span>We carried out a retrospective study including every patient who underwent renal transplantation between 2014 and 2020. They were evaluated with a systematic post-transplant renal Doppler ultrasound<span>. To identify independent risk factors for transplant renal artery stenosis we performed a </span></span>multivariate analysis.</p></div><div><h3>Results</h3><p>Seven hundred twenty-four kidney transplants were included, 12% were living donors and 88% were deceased donors. The mean age was 54.8 in recipients and 53 in donors. Transplant renal artery stenosis was diagnosed in 70 (10%) recipients, the majority in the first 6 months after surgery. 51% of patients with transplant renal artery stenosis were managed conservatively. The multivariate analysis showed diabetes mellitus, graft rejection<span>, arterial resuture and donor body mass index as independent risk factors for transplant renal artery stenosis. Survival of the grafts with transplant renal artery stenosis was 98% at 6 months and 95% at two years.</span></p></div><div><h3>Conclusions</h3><p><span><span>The systematic performance of Doppler ultrasound in the immediate post-transplant period diagnosed 10% of transplant renal artery stenosis in our cohort. Despite the above risk factors, an adequate monitoring and treatment could avoid the increased risk of </span>graft loss </span>in patients with transplant renal artery stenosis.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Actas urologicas espanolas","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2173578623001026","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Introduction and objectives
Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation which estimated incidence is 13%. It could cause refractory arterial hypertension, kidney dysfunction and premature death in transplant recipients.
Methods
We carried out a retrospective study including every patient who underwent renal transplantation between 2014 and 2020. They were evaluated with a systematic post-transplant renal Doppler ultrasound. To identify independent risk factors for transplant renal artery stenosis we performed a multivariate analysis.
Results
Seven hundred twenty-four kidney transplants were included, 12% were living donors and 88% were deceased donors. The mean age was 54.8 in recipients and 53 in donors. Transplant renal artery stenosis was diagnosed in 70 (10%) recipients, the majority in the first 6 months after surgery. 51% of patients with transplant renal artery stenosis were managed conservatively. The multivariate analysis showed diabetes mellitus, graft rejection, arterial resuture and donor body mass index as independent risk factors for transplant renal artery stenosis. Survival of the grafts with transplant renal artery stenosis was 98% at 6 months and 95% at two years.
Conclusions
The systematic performance of Doppler ultrasound in the immediate post-transplant period diagnosed 10% of transplant renal artery stenosis in our cohort. Despite the above risk factors, an adequate monitoring and treatment could avoid the increased risk of graft loss in patients with transplant renal artery stenosis.