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Three-Dimensional Computed Tomography Reconstruction in Transplant Renal Artery Stenosis.

Three-Dimensional Computed Tomography Reconstruction in Transplant Renal Artery Stenosis.
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Zhang X, Wang H, Liu S, Yan J, Liu X, Xu D, Tian C,


Zhang X, Wang H, Liu S, Yan J, Liu X, Xu D, Tian C, (click to view)

Zhang X, Wang H, Liu S, Yan J, Liu X, Xu D, Tian C,

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Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation 2017 03 22() doi 10.6002/ect.2016.0156
Abstract
OBJECTIVES
Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis.

MATERIALS AND METHODS
During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomography reconstruction and were treated with endovascular approaches or medically managed.

RESULTS
Ten patients were diagnosed with transplant renal artery stenosis by 3-dimensional computed tomography reconstruction. No evidence of contrast-induced nephrotoxicity was observed. Nine of the 10 patients underwent percutaneous transluminal angio-plasty, whereas the remaining patient was treated conservatively. Procedural success rate was 100%. Patients were followed for a mean period of 20 ± 3 months. Blood pressure improved from a mean of 163/90 to 132/73 mm Hg at the end of the follow-up period. In the 9 patients who underwent angioplasty, serum creatinine improved from 198 ± 24 to 134 ± 16 μmol/L at the end of the follow-up period. The cystatin C level in some patients declined after interventional therapy.

CONCLUSIONS
Three-dimensional computed tomography reconstruction is a safe choice for patients who present with increased serum creatinine levels and refractory hypertension. Percutaneous transluminal angioplasty is the preferred therapeutic technique for transplant renal artery stenosis.

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