Three-Dimensional Computed Tomography Reconstruction in Transplant Renal Artery Stenosis

Objectives: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis. Materials and Methods: During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomography reconstruction and were treated with endo vascular approaches or medically managed. Results: Ten patients were diagnosed with transplant renal artery stenosis by 3-dimensional computed tomography reconstruction. No evidence of contrast-induced nephrotoxicity was observed. Nine of the 10 patients underwent percutaneous transluminal angioplasty, whereas the remaining patient was treated conservatively. Procedural success rate was 100%. Patients were followed for a mean period of 20 +/- 3 months. Blood pressure improved from a mean of 163/90 to 132/73 mm Hg at the end of the follow-up period. In the 9 patients who underwent angioplasty, serum creatinine improved from 198 +/- 24 to 134 +/- 16 mu mol/L at the end of the follow-up period. The cystatin C level in some patients declined after interventional therapy. Conclusions: Three-dimensional computed tomography reconstruction is a safe choice for patients who present with increased serum creatinine levels and refractory hypertension. Percutaneous transluminal angioplasty is the preferred therapeutic technique for transplant renal artery stenosis.