Transplant renal artery stenosis: Study of incidence using doppler ultrasound, risk factors and analysis is effect in graft outcomes

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
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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.

移植肾动脉狭窄:利用多普勒超声研究发病率、风险因素并分析其对移植结果的影响。
导言和目的:移植肾动脉狭窄(TRAS)是肾移植后的一种血管并发症,估计发生率为 13%。它可导致移植受者出现难治性动脉高血压、肾功能障碍和过早死亡:我们进行了一项回顾性研究,包括 2014 年至 2020 年间接受肾移植的所有患者。方法:我们对 2014 年至 2020 年间接受肾移植的所有患者进行了回顾性研究,并对他们进行了移植后肾脏多普勒超声系统评估。为了确定移植肾动脉狭窄的独立风险因素,我们进行了多变量分析:共纳入 724 例肾移植,其中 12% 为活体捐献者,88% 为死亡捐献者。受者的平均年龄为 54.8 岁,供者的平均年龄为 53 岁。70名受者(10%)被诊断出移植肾动脉狭窄,其中大多数是在术后6个月内。51%的移植肾动脉狭窄患者接受了保守治疗。多变量分析显示,糖尿病、移植物排斥反应、动脉缝合和供体体重指数是移植肾动脉狭窄的独立风险因素。移植肾动脉狭窄患者6个月的存活率为98%,两年的存活率为95%:结论:在移植后的第一时间系统地进行多普勒超声检查,可以诊断出我们队列中10%的移植肾动脉狭窄。尽管存在上述风险因素,但适当的监测和治疗可避免移植肾动脉狭窄患者移植物损失风险的增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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