title: Long-term outcomes of transplant recipients referred for angiography for suspected transplant renal artery stenosis.
abstract: Our aim was to study the long-term outcomes of all transplant recipients who underwent angiography for suspected TRAS at our institution. The patients were divided into TRAS+ve and TRAS-ve groups based upon angiographically confirmed results. TRAS was confirmed in 58.1% of 74 patients with median time of 8.9 months. Primary angioplasty alone was performed in 56% of patients with TRAS, while the remaining had PTA with stent (PTAS). There was reduction in systolic and diastolic BP (165 ± 19-136 ± 15 mmHg and 82 ± 14 mmHg to 68 ± 12 mmHg; p < 0.05) and number of antihypertensive drugs (3.5 ± 0.9-2.7 ± 1.0; p < 0.05). Overall, graft survival and patient survival from time of transplant were similar in both groups. Graft function was similar for the patients with treated TRAS+ve as compared to TRAS-ve over time. Graft survival and patient survival when compared to an age- and year of transplant-matched cohort control group were also similar. In conclusion, angiography for suspected TRAS is more likely to yield a confirmatory result early in the transplant course as compared to late. Treatment of TRAS in these patients had sustained long-term graft function. Alternative etiologies of HTN and graft dysfunction should be sought for recipients further out from transplant.
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Anum
authors.initials: A
authors.lastname: Ali
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Dennis
authors.initials: D
authors.lastname: Mishler
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Tim
authors.initials: T
authors.lastname: Taber
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: David
authors.initials: D
authors.lastname: Agarwal
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Yaqub
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Mujtaba
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: William
authors.initials: W
authors.lastname: Goggins
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Asif
authors.initials: A
authors.lastname: Sharfuddin
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D017130:Angioplasty; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: graft function; graft survival; hypertension; kidney transplant; transplant renal artery stenosis