[A review of 72 renal artery stenoses in a series of 715 kidney transplantations in children].
In a series of 715 renal transplantations performed between 1973 and 1989, 72 cases of renal artery stenosis (RAS) in 69 children (9.7%) were managed at Hôpital Necker Enfants Malades. Forty cases of RAS were treated exclusively by antihypertensive drugs. A good result was obtained in 82.5% of cases. Thirty three transluminal angioplasties (TLA) were performed in 23 children with 26 RAS. A good clinical result was obtained in 15 children with a total of 17 stenoses, corresponding to a success rate of 65%. Transluminal dilatation of anastomotic stenoses always failed. There were no cases of transplant thrombosis. Eleven RAS were operated, including 5 after failure of TLA. Eight patients (73%) obtained a clinical improvement. There were 2 postoperative thromboses. Antihypertensive treatment must be administered in every case. If medical treatment fails, and with the exception of anastomotic stenoses, TLA should be the first-line procedure, while surgery is reserved for failures of TLA and for anastomotic stenoses.
Fontaine
E
E
Service de Chirurgie Urologique, Hôpital Ambroise Paré (Paris-Ouest), Boulogne.
Barthelemy
Y
Y
Gagnadoux
M F
MF
Cukier
J
J
Broyer
M
M
Beurton
D
D
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000714:Anastomosis, Surgical; D000800:Angioplasty, Balloon; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001926:Brain Death; D002648:Child; D002675:Child, Preschool; D006085:Graft Survival; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007223:Infant; D016030:Kidney Transplantation; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D015996:Survival Rate; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D014019:Tissue Donors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
Revue de 72 sténoses de l'artère rénale dans une série de 715 transplantations rénales chez l'enfant.