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Amaç: Transplant renal arter stenozu (TRAS) ve posttransplant arterial hipertansiyon allograft disfonksiyon ve greft kaybının tedavi edilebilir bir nedenidir. TRAS gelişiminde risk faktörleri arasında donor yaşı, uzun sureli gecikmiş greft fonksiyonu, soğuk iskemi süresi, eşzamanlı CMV enfeksiyonu varlığı ve cerrahi teknik vardır. Perkütan Translüminal Anjioplasti (PTA) %60-90 vakada renal perfüzyonu sağlar. Bu çalışmamızda, kliniğimizdeki 6 TRAS vakasının özelliklerini inceledik. Gereç ve Yöntem: Kliniğimizde, 2017 yılında böbrek nakli yapılan hastalar tıbbi kayıtlardan inceledik. TRAS gelişen hastaların yaş, cinsiyet, nakil sırasındaki diğer bulguları ve demografik özellikleri kaydedildi. Bulgular: Yirmi altı vakanın altısında TRAS saptandı. İliak arter darlık varlığı ile birlikte renal arter stenozu olan 2 hastada CMV PCR pozitifliği saptandı. Hastalara PTA ve stent implantasyonu uygulandı. Takiplerde antihipertansif tedavi ihtiyacı azaldı. Sonuç: TRAS, böbrek nakli sonrasında allograft disfonksiyonun nedenlerinden biridir. Sonuç olarak allograft disfonksiyonda akılda tutulmalıdır. Diğer risk fatörlerine ek olarak, cerrahi teknik de TRAS gelişiminde önemli bir rol oynar. Greft fonksiyonu erken girişimle korunabilir.
Purpose: Transplant renal arterial stenosis (TRAS) and posttransplant arterial hypertension are a treatable cause of allograft dysfunction and greft loss. Risk factors in the development of TRAS include the donor age, the long-term delayed greft function, the time of cold scem, the presence of simultaneous CMV infection and the surgical technique. Percutaneous Transliminal Anjioplasty (PTA) provides renal perfusion in 60-90% of cases. In this study, we examined the characteristics of the 6 TRAS cases in our clinic. In our clinic, we examined patients with a kidney transplant in 2017 from medical records. The age, gender, other findings during transplantation and demographic characteristics of developing patients were recorded. Results: Twenty-six tracks were found in six tracks. In 2 patients with renal artery stenosis with the presence of connective artery density, CMV PCR positive was detected. Patients received PTA and stent implantation. The need for antihypertensive treatment was reduced. The result: TRAS is one of the causes of allograft dysfunction after a kidney transplant. As a result, allograft disfunction should be kept in mind. In addition to other risk factors, the surgical technique also plays an important role in the development of TRAS. Greft function can be preserved by early initiation.
Objective: Transplant renal artery stenosis (TRAS) and post-transplant arterial hypertension is a treatable cause of allograft dysfunction and graft loss. The risk factors for the development of TRAS include: donor age, prolonged and delayed graft function, cold ischemia time,concomitantCMV infection and surgical technique. Percutaneous transluminal angioplasty (PTA) has proven successful in treating TRAS in 60-90% of cases by providing renal reperfusion. In this study,we evaluated six TRAS cases in our clinic. Material and Methods: We evaluated patients retrospectively from medical records who underwent transplantation in 2017. We recorded the age, gender, creatinine, other findings during transplantation, and the demographic features of transplant patients with TRAS. Results: TRAS was reported in 6 of 26 cases. The presence of iliac artery stenosis associated with renal artery stenosis was seen in two patients with CMV PCR (+). Patients underwent PTA and stent implantation. The need for antihypertensive treatment of the patients lessened during follow-up. Conclusion: TRAS is one of the reasons for allograft dysfunction after kidney transplantation. For this reason it should be kept in mind when determining the cause of the allograft disfunction. In addition to other risk factors, surgical technique plays an important role in the development of TRAS. Graft function can be preserved with early intervention.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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