Gunawardena Thilina, Sharma Hemant
From the Department of Renal Transplant, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Exp Clin Transplant. 2022 Dec;20(12):1049-1057. doi: 10.6002/ect.2022.0334.
Transplant renal artery stenosis is an increasingly recognized vascular complication after renal transplant. It can result in posttransplant hypertension and graft dysfunction and eventually in graft loss. Timely diagnosis and appropriate intervention for clinically significant transplant renal artery stenosis can potentially halt or reverse these adverse effects, leading to better outcomes. Duplex ultrasonography is the imaging modality of choice to screen suspected cases. Some patients with transplant renal artery stenosis will require invasive treatment with endovascular intervention or surgery, whereas others can be safely treated with blood pressure control and follow-up. In this review, we aimed to discuss the epidemiology, clinical presentation, pathogenesis, diagnosis, and management of this common posttransplant complication.
移植肾动脉狭窄是肾移植后一种日益被认识到的血管并发症。它可导致移植后高血压和移植物功能障碍,并最终导致移植物丢失。对具有临床意义的移植肾动脉狭窄进行及时诊断和适当干预有可能阻止或逆转这些不良反应,从而带来更好的结果。双功超声检查是筛查疑似病例的首选成像方式。一些移植肾动脉狭窄患者需要进行血管内介入或手术等侵入性治疗,而其他患者可通过控制血压和随访得到安全治疗。在本综述中,我们旨在讨论这种常见的移植后并发症的流行病学、临床表现、发病机制、诊断和管理。