An Important Complication After Transplantation: Transplant Renal Artery Stenosis

Öz

Renal transplantation is a preferred treatment option because of its low long-term mortality and increased quality of life. However, complications after transplantation affect graft and patient survival. Transplant Renal Artery Stenosis (TRAS) is the most common vascular complication following renal transplantation affecting 1-23% of patients. Although it usually causes refractory hypertension, it can also cause graft loss. Although Peripheral Angiography (Digital subtraction angiography) is the gold standard for the diagnosis of TRAS, Doppler USG has become a primary imaging method because it is portable, inexpensive and noninvasive. There are surgical and endoluminal options in the treatment. In this report, a 16-year-old girl who had renal artery stenosis at the 4th month after renal transplantation and underwent percutaneous transluminal balloon angioplasty was reported. She is now in her second year of transplantation without any need for antihypertensive treatment and with preserved graft function.

Anahtar Kelimeler

• Renal transplantation
• Renal artery stenosis
• TRAS

Böbrek Nakli Sonrası Önemli Bir Komplikasyon: Transplant Renal Arter Stenozu

Öz

Renal transplantasyon, düşük uzun dönem mortalite ve artmış hayat kalitesi sağlaması nedeniyle tercih edilen bir tedavi seçeneğidir. Bununla birlikte transplantasyon sonrası gelişen komplikasyonlar nakil böbreğin ve hastanın sağ kalımını etkiler. Transplant Renal Arter Stenozu (TRAS), renal transplant sonrası en sık görülen vasküler komplikasyondur. Hastaların %1-23 ünü etkiler. Çoğunlukla refrakter hipertansiyona neden olsa da greft kaybına da yol açabilmektedir. Renal transplantasyonun ardından ikinci günde görülebileceği gibi operasyondan yıllar sonra da görülebilmektedir. Periferik Anjiografi (Digital subtraction angiography) TRAS tanısı için altın standart olmakla birlikte Doppler USG taşınabilir, ucuz ve noninvaziv olması nedeniyle primer görüntüleme yöntemi haline gelmiştir. Tedavide cerrahi ve endoluminal seçenekler bulunmaktadır. Bu yazıda renal transplantasyon sonrası 4. ayda renal arter stenozu gelişen ve perkutan transluminal balon anjioplasti uygulanarak izlemine nakil sonrası ikinci yılında, antihipertansif tedavi ihtiyacı olmadan ve greft fonksiyonu korunmuş halde devam edilen 16 yaşındaki bir kız hasta bildirildi.

Anahtar Kelimeler

• Renal transplantasyon
• Renal arter stenozu
• TRAS

Kaynakça

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