Diagnosis and treatment of transplanted renal artery stenosis in 7 children from deceased donors
10.3760/cma.j.cn421203-20211129-00299
- VernacularTitle:儿童肾移植后移植肾动脉狭窄7例诊疗分析
- Author:
Pengfei GAO
1
;
Jun LI
;
Wenrui WU
;
Chenglin WU
;
Qiang ZHANG
;
Huanxi ZHANG
;
Qian FU
;
Longshan LIU
;
Yonghui HUANG
;
Shujuan LI
;
Changxi WANG
Author Information
1. 中山大学附属第一医院器官移植中心，广州 510080
- Keywords:
Kidney transplantation;
Renal artery stenosis;
Percutaneous transluminal angioplasty
- From:
Chinese Journal of Organ Transplantation
2022;43(1):9-13
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnosis and treatment of transplanted renal artery stenosis(TRAS)in children.Methods:From January 2016 to August 2021, clinical data of 7 TRAS patients were collected.A definite diagnosis was confirmed by Doppler ultrasound and computed tomography angiography.Results:Patient age was significantly higher than donor age(11.9±3.7 vs 1.0±0.5 years, P<0.001); 5 patients had a widened diameter at stenotic grafted renal artery after intervention(1.98±0.47 vs 4.64±1.19 mm, P=0.002). A reduction in peak systolic flow velocity in stenotic segment of artery(463.3±90.6 vs 183.6±58.9 cm/s, P<0.001)and lower systolic blood pressure(137.2±15.5 vs 129.7±12.3 mmHg, P=0.029)were observed.Resistance index rose(0.38±0.22 vs 0.60±0.03, P=0.063). Significant difference of estimated glomerular filtration rate was observed at Week 4 post-operation as compared with pre-intervention.Two patients developed complications after intervention, including perirenal hematoma and stent-attached thrombus.Two patients were treated conservatively with a gradual increase in blood pressure and three antihypertensive drugs prescribed. Conclusions:Doppler ultrasound should be performed regularly after renal transplantation for detecting TRAS at an early stage in children.Interventional treatment is ideal for severe TRAS to improve perfusion and renal function.Clinicians should pay more attention to complications.
