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Diagnosis and Treatment of Renal Artery Stenosis in China in the Era of Donation After Cardiac Death

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单位: [1]Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China [2]Department of Geriatric Cardiology, The 8TH Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, P.R. China [3]Organ Transplant Institute, The 8TH Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, P.R. China [4]Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijng, P.R. China
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关键词: Atherosclerosis Hypertension Kidney Transplantation Renal Artery Obstruction

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Background: The aim of this study was to investigate the clinical features and treatment strategies of transplant renal artery stenosis (TRAS) with kidneys from donation after cardiac death (DCD). Material/Methods: We collected the clinical data of donors and recipients of single-center DCD-induced TRAS from January 2015 to June 2017. Results: All the 8 cases of TRAS were from hypertensive cerebrovascular accident DCD-originated kidneys. The mean donor age was 53.5 (45-57) years, with mean BMI 27.8 (26.4-32.3) kg/m(2), atherosclerosis index 5.8 (4.9 similar to 7.0), and renal atherosclerotic plaque. Clinical features of TRAS were: refractory hypertension with elevated serum creatinine >50%, and negative urine protein and occult blood. Ultrasound of transplanted kidneys showed renal blood flow index 0.49 (0.43 similar to 0.55). Angiography confirmed the diagnosis of renal artery trunk or secondary branch stenosis. There were 2 cases of moderate stenosis and 6 cases of severe stenosis. Six patients underwent stent implantation and 2 patients underwent balloon dilatation. Seven patients had serum creatinine recovery after interventional therapy during follow-up. The transplanted kidney of 1 patient ruptured 6 h after interventional therapy and was then resected. Conclusions: The incidence of TRAS with hypertensive cerebrovascular accident DCD-originated kidneys is relatively high, which is a warning to kidney transplant physicians. Digital subtraction angiography (DSA) is the most reliable diagnostic means of TRAS and can be performed concurrently with intervention therapy. If the donor has severe atherosclerosis, plaques that are visible to the unaided eye in the renal artery trunk should be removed as completely as possible.

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 4 区 外科 4 区 移植
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 外科 4 区 移植
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出版当年[2018]版:
Q3 SURGERY Q4 TRANSPLANTATION
最新[2023]版:
Q3 SURGERY Q3 TRANSPLANTATION

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2018版] 出版当年五年平均[2014-2018] 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
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