title: Vascular complication in live related renal transplant: An experience of 1945 cases.
abstract: OBJECTIVE
  Among the surgical complications in renal transplantation, the vascular complications are probably most dreaded, dramatic, and likely to cause sudden loss of renal allograft. We present our experience and analysis of the outcome of such complications in a series of 1945 live related renal transplants.
  
  
  METHODS
  One thousand nine hundred and forty five consecutive live related renal transplants were evaluated retrospectively for vascular complications. Complications were recorded and analyzed for frequency, time of presentation, clinical presentation, and their management.
  
  
  RESULTS
  The age of patients ranged from 6 to 56 years (mean = 42). Vascular complications were found in 25 patients (1.29%). Most common among these was transplant renal artery stenosis found in 11 (0.58%), followed by transplant reznal artery thrombosis in 9 (0.46%), renal vein thrombosis in 3 (0.15%), and aneurysm formation at arterial anastmosis in 2 (0.10%) patient. The time of presentation also varied amongst complications. All cases of arterial thrombosis had sudden onset anuria with minimal or no abdominal discomfort, while venous thrombosis presented as severe oliguria associated with intense graft site pain and tenderness. Management of cases with vascular thrombosis was done by immediate surgical exploration. Two patients of renal artery stenosis were managed with angioplasty and stent placement.
  
  
  CONCLUSIONS
  Major vascular complications are relatively uncommon after renal transplantation but still constitute an important cause of graft loss in early postoperative period. Aneurysm and vessel thrombosis usually require graft nephrectomy. Transplant renal artery stenosis is amenable to correction by endovascular techniques.
authors.affiliation: Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Aneesh
authors.initials: A
authors.lastname: Srivastava
authors.forename: Jatinder
authors.initials: J
authors.lastname: Kumar
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sharma
authors.lastname: Abhishek
authors.forename: M S
authors.initials: MS
authors.lastname: Ansari
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kapoor
keywords: Live related renal transplant; renal artery stenosis; renal artery thrombosis