Post-transplant renal artery stenosis

  • Late complication
  • Occurs at anastomosis site – between donor and recipient artery
  • Presents with severe hypertension or renal dysfunction
  • US: renal artery velocity >200 cm/s, gradient of 2:1 between stenotic and pre-stenotic segment and spectral broadening. Downstream turbulence, tardus parvus waveform distal to stenotic segment
  • False positive: kinking or tortuosity of vessels. 
  • If USG and clinical picture correlates, angiography performed directly with angioplasty and stent insertion
  • If USG and clinical picture do not correlate, non-invasive CT/MR angiography may be done
Read more

Bruno, Simona, Giuseppe Remuzzi, and Piero Ruggenenti. “Transplant renal artery stenosis.” Journal of the American Society of Nephrology 15.1 (2004): 134-141.

Chen, Wei, et al. “Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy.” Clinical kidney journal 8.1 (2015): 71-78.