Renal artery stenosis in pediatric transplant recipients

• Published in: Pediatric nephrology (Berlin, West) Vol. 1; no. 1; p. 22
• Main Authors: Malekzadeh, M, Grushkin, C M, Stanley, P, Brennan, L P, Stiles, Q R, Lieberman, E
• Format: Journal Article
• Language: English
• Published: Germany 01.01.1987
• Subjects: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Kidney Transplantation - adverse effects; Male; Renal Artery Obstruction - etiology
• DOI: 10.1007/BF00866880
• ISSN: 0931-041X

From 1967 through 1985, 400 cadaveric transplants were performed at Children Hospital of Los Angeles. Of these 400, 31 were later identified as having renal artery stenosis. No live related graft developed RAS. Of the 31 grafts, 11 were from donors less than 2 years of age. The major feature suggesting stenosis was hypertension; either persistent or a sudden exacerbation often associated with hypertensive encephalopathy. In individuals with hypertension without obvious cause, renal angiography should be promptly conducted under controlled conditions to avoid complications. The stenotic lesion involved 13 end-to-end and 19 end-to-side arterial anastomoses. Surgery for revascularization of RAS was performed in 21 of 31 with success or improvement in 14, no change in 2, and graft loss in 5. Percutaneous transluminal angioplasty was performed in 4. Two were unsuccessful, 1 was successful and 1 graft was lost. The 7 remaining patients were treated medically.