Kidney Transplant

Treatment of Renal Artery Atherosclerosis in Kidney Transplant — Transplant Renal Artery Stenosis

Renal artery atherosclerosis in kidney transplant recipients can manifest as transplant renal artery stenosis (transplant RAS), a recognised vascular complication that warrants a specific treatment approach distinct from native renal artery disease.

Clinical scenario

Kidney transplant recipient presenting with transplant renal artery stenosis — whether symptomatic or asymptomatic. This scenario applies to patients with a history of kidney transplantation who develop significant stenosis at or near the transplant renal artery.

Treatment approach (partial)

The primary treatment is endovascular, targeting the stenotic transplant artery directly. Balloon angioplasty forms the basis of intervention, with additional measures reserved for selected cases where initial treatment alone is insufficient.

The complete structured protocol — including procedural criteria, patient selection, and management of specific situations — is available via the link below.

References
DOI: 10.1053/j.ajkd.2021.06.025
Kidney transplant with RAS (symptomatic or asymptomatic).
Endovascular treatment of transplant RAS is usually very effective and seldom requires stent placement.
In a recently published single-center experience of 63 patients undergoing angioplasty for transplant RAS (86% balloon angioplasty, 14% stent placement), 1-year primary and secondary patency rates were 85% and 100%, respectively; allograft survival rates were 89% at 5 years and 85% at 10 years.
View source ↗