Case report of transplant renal artery stenosis secondary to mechanical renal artery kinking: Balloon angioplasty as a supportive diagnostic tool?

International Journal of Surgery Case Reports
Brooklyn L DeVriesDouglas Yim

Abstract

Renal vascular complications are a significant cause of morbidity in living donor renal transplantation. Among renal vascular complications, transplant renal artery stenosis (TRAS) secondary to mechanical kinking is a rare but important cause of early graft dysfunction. Identifying this phenomenon and correcting the underlying cause is critical to graft viability in the post-operative period. This case illustrates the importance of balloon angioplasty in identifying this complication and prompting surgical correction. We describe the case of a 67-year-old male who received a right-sided living donor kidney graft for Stage IV Chronic Kidney Disease secondary to biopsy proven Ig-A nephropathy. In the post-operative course, serum creatinine remained elevated and Doppler showed low-normal vascular flow velocities. Renal angiogram indicated transplant renal artery stenosis secondary to the rare phenomenon of mechanical kinking. Findings noted during unsuccessful angioplasty supported the diagnosis and surgical repositioning of the graft provided definitive repair. Post-operative serum creatine trended down and urine output improved within 24 h. Patient was stable at two month follow up. Transplant renal artery stenosis secondary to ...Continue Reading

References

Jun 17, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Mohiuddin MiahSandeep Guleria
Sep 18, 2012·Clinical Nephrology·Zelal AdibelliSimin Goral
Sep 20, 2016·Techniques in Vascular and Interventional Radiology·Kanti Pallav Kolli, Jeanne M LaBerge
Mar 30, 2019·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Nikolina Basic-JukicZeljko Kastelan
Nov 13, 2020·International Journal of Surgery·Riaz A AghaUNKNOWN SCARE Group

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