title: Interventional Therapy for Transplant Renal Artery Stenosis Is Safe and Effective in Preserving Allograft Function and Improving Hypertension.
abstract: OBJECTIVE
  To evaluate the outcomes of percutaneous intervention (PI) for transplant renal artery stenosis (TRAS).
  
  
  METHODS
  Doppler ultrasonography was used as the screening tool, and angiography was the diagnostic method for TRAS. The indications for PI were (1) a reduction in lumen diameter of >50% or (2) a mean pressure gradient of >15 mm Hg. Technical success was assessed immediately after the procedure. The short-term results of stenosis were evaluated by serum creatinine (Scr) levels and blood pressure (BP). The long-term results were assessed by graft survival and renal function.
  
  
  RESULTS
  From October 2009 to July 2015, a total of 660 patients had kidney transplantation and 22 cases underwent PI. The technical success was 100%. The mean Scr level preintervention was 321.6 ± 167.2 (range, 171.3-862.0) μmol/L, and it decreased to 145.3 ± 44.7 (range, 74.3-260.8) μmol/L 1 month postintervention ( P < .001). Blood pressure was also improved at 1 month postintervention, as assessed by systolic (157.0 ± 13.0 vs 131.0 ± 11.0 mm Hg, P < .001), diastolic (95.0 ± 5.0 vs 77.0 ± 9.0 mm Hg, P < .001), and mean arterial pressure (116.0 ± 7.0 vs 95.0 ± 9.0 mm Hg, P < .001). The patency rate was 100%, 91.7%, and 85.7% at 1, 3, and 12 months, respectively. The secondary patency rate was 100%. Graft survival was 100% during follow-up. There was no significant deterioration in graft function or BP ( P > .05) postintervention when compared to posttransplantation.
  
  
  CONCLUSIONS
  Percutaneous intervention for TRAS is safe and results in significant improvement both in allograft function and in BP.
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Wang
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.affiliation: 2 Department of Kidney Transplantation, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Jieke
authors.initials: J
authors.lastname: Yan
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Yongzheng
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Wujie
authors.initials: W
authors.lastname: Wang
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Haiyang
authors.initials: H
authors.lastname: Chang
authors.affiliation: 2 Department of Kidney Transplantation, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Wang
authors.affiliation: 3 Department of Radiology, The Jiyang People's Hospital, Jinan, Shandong, China.
authors.forename: Changjun
authors.initials: C
authors.lastname: Wang
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
authors.affiliation: 1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.
authors.forename: Yuliang
authors.initials: Y
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D005260:Female; D006085:Graft Survival; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: hypertension; percutaneous transluminal angioplasty; renal dysfunction; stent implantation; transplant renal artery stenosis