RENAL ARTERY STENOSIS IN RENAL TRANSPLANTATION ¹

Abstract

Thirty-six angiograms of cadaver renal transplants have been taken from six weeks to 46 months after transplantation. Two types of renal artery abnormalities were seen. The first was a diffuse irregularity of the renal artery seen in three patients who were undergoing severe acute rejection episodes within six weeks after transplantation. The second was a smooth stenosis of the renal artery occurring distal to the anastomosis which was seen in 14 patients, usually associated with hypertension and a bruit. An end-to-side arterial anastomosis of donor renal artery to iliac artery was performed in 34 of these 36 cases, and must be considered an Important factor in the development of these lesions. No other factor, such as histoincompatibility, preformed cytotoxic antibodies or serum cholesterol levels, could be associated with their development. Correction of one such lesion led to a marked reduction in hypertension and improvement in renal function.