Vijayvergiya Rajesh, Kaur Navjyot, Kasinadhuni Ganesh, Sharma Ashish, Lal Anupam, Sood Ashwani
Post Graduate Institute of Medical Education and Research - PGIMER, Chandigarh, India.
J Vasc Bras. 2021 Nov 29;20:e20210054. doi: 10.1590/1677-5449.210054. eCollection 2021.
Renal transplant remains the preferred therapy for end-stage renal disease (ESRD). Given the shortage of suitable donor kidneys, use of an expanded criteria donor (ECD) allows marginal kidneys to be transplanted; albeit at risk of increased graft failure due to lower nephron mass. To reduce the risk of graft failure, double kidney transplant (DKT) is advocated, with favorable outcomes. Transplant renal artery stenosis (TRAS) is one of the most common vascular complications following renal transplant. Unlike single kidney transplants, where TRAS usually presents with fluid overload, uncontrolled hypertension, and worsening kidney functions; it may be clinically silent in DKT patients since they have two functional transplanted kidneys. We hereby report a case of TRAS in a DKT patient who had 2 years of favorable clinical outcomes following successful endovascular stenting. He however recently died of COVID-19 associated pneumonitis.
肾移植仍然是终末期肾病（ESRD）的首选治疗方法。鉴于合适供体肾脏的短缺，使用扩大标准供体（ECD）可使边缘性肾脏得以移植；尽管由于肾单位数量减少而存在移植失败风险增加的情况。为降低移植失败风险，提倡进行双肾移植（DKT），其效果良好。移植肾动脉狭窄（TRAS）是肾移植后最常见的血管并发症之一。与单肾移植不同，单肾移植中TRAS通常表现为液体超负荷、难以控制的高血压和肾功能恶化；而在DKT患者中，由于他们有两个功能正常的移植肾，TRAS在临床上可能没有症状。我们在此报告一例DKT患者发生TRAS的病例，该患者在成功进行血管内支架置入术后有两年良好的临床效果。然而，他最近死于COVID-19相关性肺炎。
