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Vascular Reconstruction of Multiple Renal Arteries—A Risk Factor for Transplant Renal Artery Stenosis: Insight From a Matched Case-Control Study

Authors :
Devprakash Choudhary
Rajesh Vijayvergiya
Kamal Kishore
Vanji Nathan Subramani
Mohan Banoth
Sai Praneeth Reddy Perugu
Milind Mandwar
Bharat Bamaniya
Arun Panjathia
Parul Gupta
Shiva Kumar S. Patil
Jasmine Sethi
Ujjwal Gorsi
Sarbpreet Singh
Deepesh Kenwar
Ashish Sharma
Source :
Transplant International, Vol 37 (2024)
Publication Year :
2024
Publisher :
Frontiers Media S.A., 2024.

Abstract

Transplant Renal Artery Stenosis (TRAS) is the leading vascular complication following kidney transplantation (KT), causing premature allograft loss and increased post-KT mortality. While risk factors for TRAS, such as prolonged cold ischemia time and delayed graft function, are well-documented in deceased donor-KT, the risk factors remain less clearly defined in living donor-KT. This matched case-control study, conducted at a leading national transplant center predominantly performing living donor-KT, evaluated risk factors and long-term outcomes of clinical TRAS (cTRAS). cTRAS cases diagnosed from January 2009 to December 2022 were matched with four control kidney transplant recipients (KTRs) in a study powered to assess whether ex-vivo arterial vascular reconstruction of multiple renal arteries (VR-MRA) increases the risk of cTRAS. Among 2,454 KTs, 28 KTRs (1.14%) were diagnosed with cTRAS around 3.62 ± 1.04 months post-KT, with renal allograft dysfunction (92.86%) as the most common presenting feature. Notably, 27 cTRAS cases were successfully treated with endovascular intervention, yielding favorable outcomes over a 6–180 months follow-up period. The study identified ex-vivo VR-MRA as an independent risk factor for cTRAS (P < 0.001). cTRAS cases receiving timely treatment exhibited long-term outcomes in graft and patient survival similar to control KTRs. Early screening and timely intervention for cTRAS post-KT may improve graft and patient outcomes.

Details

Language :
English
ISSN :
14322277
Volume :
37
Database :
Directory of Open Access Journals
Journal :
Transplant International
Publication Type :
Academic Journal
Accession number :
edsdoj.17b19d01a0804a72ba1b3c5a787ad47b
Document Type :
article
Full Text :
https://doi.org/10.3389/ti.2024.13298