Transplant Renal Artery Stenosis in Thailand

SOPON JIRASIRITHAM, MD*, JIEMJITRE TAPANEEYAKORN, MD**, WIW AT TIRAPANITCH, MD*, SURASAK LEELAUDOMLIPI, MD*, SIRIWAN JIRASIRITHAM, MD***, SUTHUS SRIPHOJANART, MD*.

Affiliation : * Depanment of Surgery, ** Depanment of Radiology, *** Depanment of Anesthesiol(lgy, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

AbstractTransplant renal artery stenosis (TRAS) is one of the common vascular complications post kidney transplantation. A retrospective study ofTRAS among transplant recipients at a single transplant center in Thailand was performed from February 1986 to December 2002. Among 750 cases, 16 cases (2.1%) of TRAS were identified. Twelve cases (3.3%) were from cadaveric donors and four cases ( 1%) = were from living-related donors (p-value 0.034). Most cases presented with progressive deteriora tion of kidney graft with or without refractory hypertension. Doppler ultrasonography was used for initial screening followed by renal angiography. Fifteen cases were treated by Percutaneous Trans luminal Angioplasty (PTA) with a 73 per cent success rate. Five cases underwent surgical revascula rization with an 80 per cent success rate. Two cases (13%) of successful PTA showed recurrent stenosis with 46 months follow-up which were successfully treated by repeated PTA with stents.

Keywords : Transplant Renal Artery Stenosis, Kidney Transplantation, Vascular Complication

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