04 February 2020 : Original article
Diagnosis and Treatment of Renal Artery Stenosis in China in the Era of Donation After Cardiac DeathQiang Wang1ABCD, Xiaoli Li2ABCD, Zhijia Liu3ABCD, Junnan Xu3B, Yong Han3B, Tao Yu3C, Song Chen4C, Yuzhe Tang4D, Yubao Liu4D, Xiang Li3AEFG*
Ann Transplant 2020; 25:e918076
BACKGROUND: The aim of this study was to investigate the clinical features and treatment strategies of transplant renal artery stenosis (TRAS) with kidneys from donation after cardiac death (DCD).
MATERIAL AND METHODS: We collected the clinical data of donors and recipients of single-center DCD-induced TRAS from January 2015 to June 2017.
RESULTS: All the 8 cases of TRAS were from hypertensive cerebrovascular accident DCD-originated kidneys. The mean donor age was 53.5 (45~57) years, with mean BMI 27.8 (26.4~32.3) kg/m², atherosclerosis index 5.8 (4.9~7.0), and renal atherosclerotic plaque. Clinical features of TRAS were: refractory hypertension with elevated serum creatinine >50%, and negative urine protein and occult blood. Ultrasound of transplanted kidneys showed renal blood flow index 0.49 (0.43~0.55). Angiography confirmed the diagnosis of renal artery trunk or secondary branch stenosis. There were 2 cases of moderate stenosis and 6 cases of severe stenosis. Six patients underwent stent implantation and 2 patients underwent balloon dilatation. Seven patients had serum creatinine recovery after interventional therapy during follow-up. The transplanted kidney of 1 patient ruptured 6 h after interventional therapy and was then resected.
CONCLUSIONS: The incidence of TRAS with hypertensive cerebrovascular accident DCD-originated kidneys is relatively high, which is a warning to kidney transplant physicians. Digital subtraction angiography (DSA) is the most reliable diagnostic means of TRAS and can be performed concurrently with intervention therapy. If the donor has severe atherosclerosis, plaques that are visible to the unaided eye in the renal artery trunk should be removed as completely as possible.
Keywords: atherosclerosis, Hypertension, Kidney Transplantation, Renal Artery Obstruction, Angiography, Digital Subtraction, Creatinine, Kidney, Middle Aged, Postoperative Complications, young adult
17 May 2023 : Original articleResults of Liver Retransplantation After Rescue Hepatectomy: A Single-Center Study
Ann Transplant In Press; DOI: 10.12659/AOT.939557
10 May 2023 : Original articleIncidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...
Ann Transplant In Press; DOI: 10.12659/AOT.939143
Most Viewed Current Articles
24 Aug 2021 : Review articleNormothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case reportCombined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...
Ann Transplant 2022; 27:e935860