Keywords
Kidney transplantation
Renal artery stenosis
Percutaneus transluminal angioplasty
Renal artery stenosis
Percutaneus transluminal angioplasty
How to Cite
Szczerbiński, J., Szlęzak, K., Bojakowski, K., & Andziak , P. (2023). Endovascular treatment of allogeneic kidney transplant artery stenosis. Wiedza Medyczna, 4(2), 6-11. https://doi.org/10.36553/wm.140
Abstract
Recent studies have questioned the effectiveness of surgical treatment of renal artery stenosis. However, patients with artery stenosis of the solitary kidney may benefit most from endovascular therapy. Transplant renal artery stenosis is a cause of organ function deterioration, potentially leading to graft loss and increased mortality in the group of patients affected by this complication. However, we do not have data on the optimal treatment of transplant renal artery stenosis. Therapeutic methods includes conservative treatment and possible qualification for surgical treatment. Performing endovascular intervention offers the chance to correct the stenosis and return proper function to the transplanted kidney. Various methods are used during surgery: angioplasty, and stent implantation, including devices that release local antiproliferative drugs. At present, a timely intervention appears to offer the same chances of long-term graft function and survival as in kidney transplant recipients who do not develop TRAS. Data on epidemiology, risk factors and treatment outcomes are sparse, and further studies are needed.
References
1. Roustan FR, Lareyre F, Bentellis I, Haider R, Torrino S, Sedat J, Albano L, Jean-Baptiste E, Raffort J, Durand M. Endovascular Treatment of Transplant Renal Artery Stenosis: Evaluation of Postoperative Outcomes and Risk Factors for Recurrence. Angiology. 2019 Mar;70(3):249-256. doi: 10.1177/0003319718787665. Epub 2018 Jul 15. PMID: 30009628.
2. Fervenza FC, Lafayette RA, Alfrey EJ, Petersen J. Renal artery stenosis in kidney transplants. Am J Kidney Dis. 1998 Jan;31(1):142-8. doi: 10.1053/ajkd.1998.v31.pm9428466. PMID: 9428466.
3. Audard V, Matignon M, Hemery F, Snanoudj R, Desgranges P, Anglade MC, Kobeiter H, Durrbach A, Charpentier B, Lang P, Grimbert P. Risk factors and long-term outcome of transplant renal artery stenosis in adult recipients after treatment by percutaneous transluminal angioplasty. Am J Transplant. 2006 Jan;6(1):95-9. doi: 10.1111/j.1600-6143.2005.01136.x. PMID: 16433762.
4. Kamali K, Abbasi MA, Behzadi AH, Mortazavi A, Bastani B. Incidence and risk factors of transplant renal artery stenosis in living unrelated donor renal transplantation. J Ren Care. 2010 Sep;36(3):149-52. doi: 10.1111/j.1755-6686.2010.00188.x. PMID: 20690968.
5. Nicholson ML, Yong C, Trotter PB, Grant L, Hosgood SA. Risk factors for transplant renal artery stenosis after live donor transplantation. Br J Surg. 2019 Feb;106(3):199-205. doi: 10.1002/bjs.10997. Epub 2018 Oct 22. PMID: 30346041.
6. Ali A, Mishler D, Taber T, Agarwal D, Yaqub M, Mujtaba M, Goggins W, Sharfuddin A. Long-term outcomes of transplant recipients referred for angiography for suspected transplant renal artery stenosis. Clin Transplant. 2015 Sep;29(9):747-55. doi: 10.1111/ctr.12574. Epub 2015 Jul 14. PMID: 26052624.
7. GEDDES CC, MCMANUS SK, KOTEESWARAN S, BAXTER GM. Long-term outcome of transplant renal artery stenosis managed conservatively or by radiological intervention. Clin Transplant 2008: 22: 572.
8. Ngo AT, Markar SR, De Lijster MS, Duncan N, Taube D, Hamady MS. A Systematic Review of Outcomes Following Percutaneous Transluminal Angioplasty and Stenting in the Treatment of Transplant Renal Artery Stenosis. Cardiovasc Intervent Radiol. 2015 Dec;38(6):1573-88. doi: 10.1007/s00270-015-1134-z. Epub 2015 Jun 19. PMID: 26088719.
9. ASTRAL Investigators, Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, Carr S, Chalmers N, Eadington D, Hamilton G, Lipkin G, Nicholson A, Scoble J. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009 Nov 12;361(20):1953-62. doi: 10.1056/NEJMoa0905368. PMID: 19907042
10. Macchini M, Mokrane T, Darcourt J, Bellière J, Kamar N, Candelari R, Rousseau H, Meyrignac O. Percutaneous transluminal angioplasty alone versus stent placement for the treatment of transplant renal artery stenosis. Diagn Interv Imaging. 2019 Sep;100(9):493-502. doi: 10.1016/j.diii.2019.03.010. Epub 2019 Apr 2. PMID: 30952527.
11. Chen L-X, De Mattos A, Bang H, et al. Angioplasty vs stent in the treatment of transplant renal artery stenosis. Clin Transplant. 2018;32:e13217. https://doi.org/10.1111/ctr.13217
12. Hanna RF, Hao F, Kraus CF, Mitsopoulos G, Goldstein GE, Weintraub J, Sperling D, Susman J, Schlossberg P, Sheynzon V. Renal Transplant Arterial Stenosis Treated With Bare-Metal Versus Drug-Eluting Stents: Comparison of Treatment Outcomes. Transplant Proc. 2015 Dec;47(10):2881-5. doi: 10.1016/j.transproceed.2015.09.062. PMID: 26707307.
13. Li CM, Shang T, Tian L, Zhang HK. Short-Term Outcomes Using a Drug-Coated Balloon for Transplant Renal Artery Stenosis. Ann Transplant. 2018 Jan 26;23:75-80. doi: 10.12659/aot.906658. PMID: 29371586; PMCID: PMC6248045.
14. Roustan FR, Lareyre F, Bentellis I, Haider R, Torrino S, Sedat J, Albano L, Jean-Baptiste E, Raffort J, Durand M. Endovascular Treatment of Transplant Renal Artery Stenosis: Evaluation of Postoperative Outcomes and Risk Factors for Recurrence. Angiology. 2019 Mar;70(3):249-256. doi: 10.1177/0003319718787665. Epub 2018 Jul 15. PMID: 30009628.
15. Hurst FP, Abbott KC, Neff RT, Elster EA, Falta EM, Lentine KL, Agodoa LY, Jindal RM. Incidence, predictors and outcomes of transplant renal artery stenosis after kidney transplantation: analysis of USRDS. Am J Nephrol. 2009;30(5):459-67. doi: 10.1159/000242431. Epub 2009 Sep 24. PMID: 19776559.
16. Patel U, Kumar S, Johnson OW, Jeon JH, Das R. Long-term Graft and Patient Survival after Percutaneous Angioplasty or Arterial Stent Placement for Transplant Renal Artery Stenosis: A 21-year Matched Cohort Study. Radiology. 2019 Feb;290(2):555-563. doi: 10.1148/radiol.2018181320. Epub 2018 Nov 6. PMID: 30398440.
2. Fervenza FC, Lafayette RA, Alfrey EJ, Petersen J. Renal artery stenosis in kidney transplants. Am J Kidney Dis. 1998 Jan;31(1):142-8. doi: 10.1053/ajkd.1998.v31.pm9428466. PMID: 9428466.
3. Audard V, Matignon M, Hemery F, Snanoudj R, Desgranges P, Anglade MC, Kobeiter H, Durrbach A, Charpentier B, Lang P, Grimbert P. Risk factors and long-term outcome of transplant renal artery stenosis in adult recipients after treatment by percutaneous transluminal angioplasty. Am J Transplant. 2006 Jan;6(1):95-9. doi: 10.1111/j.1600-6143.2005.01136.x. PMID: 16433762.
4. Kamali K, Abbasi MA, Behzadi AH, Mortazavi A, Bastani B. Incidence and risk factors of transplant renal artery stenosis in living unrelated donor renal transplantation. J Ren Care. 2010 Sep;36(3):149-52. doi: 10.1111/j.1755-6686.2010.00188.x. PMID: 20690968.
5. Nicholson ML, Yong C, Trotter PB, Grant L, Hosgood SA. Risk factors for transplant renal artery stenosis after live donor transplantation. Br J Surg. 2019 Feb;106(3):199-205. doi: 10.1002/bjs.10997. Epub 2018 Oct 22. PMID: 30346041.
6. Ali A, Mishler D, Taber T, Agarwal D, Yaqub M, Mujtaba M, Goggins W, Sharfuddin A. Long-term outcomes of transplant recipients referred for angiography for suspected transplant renal artery stenosis. Clin Transplant. 2015 Sep;29(9):747-55. doi: 10.1111/ctr.12574. Epub 2015 Jul 14. PMID: 26052624.
7. GEDDES CC, MCMANUS SK, KOTEESWARAN S, BAXTER GM. Long-term outcome of transplant renal artery stenosis managed conservatively or by radiological intervention. Clin Transplant 2008: 22: 572.
8. Ngo AT, Markar SR, De Lijster MS, Duncan N, Taube D, Hamady MS. A Systematic Review of Outcomes Following Percutaneous Transluminal Angioplasty and Stenting in the Treatment of Transplant Renal Artery Stenosis. Cardiovasc Intervent Radiol. 2015 Dec;38(6):1573-88. doi: 10.1007/s00270-015-1134-z. Epub 2015 Jun 19. PMID: 26088719.
9. ASTRAL Investigators, Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, Carr S, Chalmers N, Eadington D, Hamilton G, Lipkin G, Nicholson A, Scoble J. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009 Nov 12;361(20):1953-62. doi: 10.1056/NEJMoa0905368. PMID: 19907042
10. Macchini M, Mokrane T, Darcourt J, Bellière J, Kamar N, Candelari R, Rousseau H, Meyrignac O. Percutaneous transluminal angioplasty alone versus stent placement for the treatment of transplant renal artery stenosis. Diagn Interv Imaging. 2019 Sep;100(9):493-502. doi: 10.1016/j.diii.2019.03.010. Epub 2019 Apr 2. PMID: 30952527.
11. Chen L-X, De Mattos A, Bang H, et al. Angioplasty vs stent in the treatment of transplant renal artery stenosis. Clin Transplant. 2018;32:e13217. https://doi.org/10.1111/ctr.13217
12. Hanna RF, Hao F, Kraus CF, Mitsopoulos G, Goldstein GE, Weintraub J, Sperling D, Susman J, Schlossberg P, Sheynzon V. Renal Transplant Arterial Stenosis Treated With Bare-Metal Versus Drug-Eluting Stents: Comparison of Treatment Outcomes. Transplant Proc. 2015 Dec;47(10):2881-5. doi: 10.1016/j.transproceed.2015.09.062. PMID: 26707307.
13. Li CM, Shang T, Tian L, Zhang HK. Short-Term Outcomes Using a Drug-Coated Balloon for Transplant Renal Artery Stenosis. Ann Transplant. 2018 Jan 26;23:75-80. doi: 10.12659/aot.906658. PMID: 29371586; PMCID: PMC6248045.
14. Roustan FR, Lareyre F, Bentellis I, Haider R, Torrino S, Sedat J, Albano L, Jean-Baptiste E, Raffort J, Durand M. Endovascular Treatment of Transplant Renal Artery Stenosis: Evaluation of Postoperative Outcomes and Risk Factors for Recurrence. Angiology. 2019 Mar;70(3):249-256. doi: 10.1177/0003319718787665. Epub 2018 Jul 15. PMID: 30009628.
15. Hurst FP, Abbott KC, Neff RT, Elster EA, Falta EM, Lentine KL, Agodoa LY, Jindal RM. Incidence, predictors and outcomes of transplant renal artery stenosis after kidney transplantation: analysis of USRDS. Am J Nephrol. 2009;30(5):459-67. doi: 10.1159/000242431. Epub 2009 Sep 24. PMID: 19776559.
16. Patel U, Kumar S, Johnson OW, Jeon JH, Das R. Long-term Graft and Patient Survival after Percutaneous Angioplasty or Arterial Stent Placement for Transplant Renal Artery Stenosis: A 21-year Matched Cohort Study. Radiology. 2019 Feb;290(2):555-563. doi: 10.1148/radiol.2018181320. Epub 2018 Nov 6. PMID: 30398440.
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