title: Primary endoluminal stenting of transplant renal artery stenosis from cadaver and non-heart-beating donor kidneys.
abstract: This study evaluated the efficacy of primary endovascular stenting in cases of transplant renal artery stenosis (TRAS) from cadaver and non-heart-beating donor kidneys. Patients with TRAS (n = 13) from a single-centre transplant population (n = 476) were treated by primary percutaneous angioplasty and endovascular stenting. The short-term efficacy of this intervention is demonstrated in terms of serum creatinine, glomerular filtration rate (GFR) biochemical, anti-hypertensive medications and mean arterial blood pressure control. Stenting for TRAS was performed in male (n = 10) and female (n = 3) recipients. The median age at transplantation was 55 yr (range 10-67 yr). Stenting occurred at a median duration of 410 d post-transplantation (range 84-5799 d). Mean serum creatinine (pre, 247 micromol/L; post, 214 micromol/L; p = 0.002), GFR (pre, 82.6 mL/min; post, 100.9 mL/min; p < 0.001), arterial blood pressure (pre, 104 mmHg; post, 97 mmHg; p = 0.036) and the number of anti-hypertensive medications required (pre, 3.4; post, 3.0; p = 0.002) showed significant improvement after post-endovascular therapy. There were no serious complications encountered. Primary endovascular stenting of TRAS produces a significant improvement in biochemical parameters of renal graft function and in blood pressure stability, with the benefit of low patient morbidity and single arterial puncture. Primary endoluminal stenting of TRAS is a safe and effective procedure for the treatment of TRAS.
authors.affiliation: Department of Surgery, University Hospitals of Leicester, NHS Trust, UK.
authors.forename: D
authors.initials: D
authors.lastname: Ridgway
authors.forename: S A
authors.initials: SA
authors.lastname: White
authors.forename: M
authors.initials: M
authors.lastname: Nixon
authors.forename: S
authors.initials: S
authors.lastname: Carr
authors.forename: K
authors.initials: K
authors.lastname: Blanchard
authors.forename: M L
authors.initials: ML
authors.lastname: Nicholson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017130:Angioplasty; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002102:Cadaver; D002648:Child; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006323:Heart Arrest; D006339:Heart Rate; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000453:epidemiology / Q000628:therapy*; D015607:Stents; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D003404:Creatinine