COMPLICATIONS - CARDIOVASCULAR

S. Gang, U. Hegde, K. Gohel, M. Rajapurkar
Nephrology, Muljibhai Patel Urological Hospital, Nadiad/INDIA

Body: Introduction: Transplant renal artery stenosis (TRAS) is an uncommon but, potentially curable cause of refractory hypertension and allograft dysfunction. Percutaneous endovascular interventions are currently the favored method of managing this complication. The aim of this study was to assess the outcome of percutaneous transluminal angioplasty (PTA) and stent placement as the primary treatment of TRAS. Methods: In our transplant center out of 1730 renal transplants performed between 1981 and 2009, 17 patients were diagnosed to have TRAS. TRAS was suspected on basis of difficult to control hypertension (11 patients) and unexplained allograft dysfunction (6 patients). Significant TRAS was diagnosed if > 60% stenosis was detected on arteriography. The effect of PTA and stent placement on blood pressure control and allograft dysfunction was analyzed. Results: PTA and PTA with stenting were performed successfully in 6 and 9 patients respectively. One patient had graft artery thrombosis and one patient with tight stenosis could not be dilated. Median follow up was 18 months (Range 12 - 156 months). There was a significant in systolic blood pressure (164+ 20 to 138+23 mm Hg) and diastolic blood pressure (100+13 to 86+ mm Hg). There was a significant reduction in the need for antihypertensive medication (3.1 to 2.43 pill/day). The renal function stabilized but no improvement was noted. Conclusion: TRAS can be successfully managed by minimally invasive technique like PTA and PTA with stenting.

Disclosure: All authors have declared no conflicts of interest.