肾移植术后肾动脉狭窄的介入放射学管理:单中心经验与管理策略
Interventional Radiology Management of Renal Artery Stenosis After Kidney Transplant: Single-Center Experience and Management Strategies.
作者信息
Mirza Ahmad, Khan Munazza, Baig Usman, Beigh Shameem, Gani Imran
机构信息
Surgery Division, Wellstar MCG Health, Augusta University, Augusta, GA 30912, USA.
Medical University-Pleven, 1, Saint Kliment Ohridski Street, 5800 Pleven, Bulgaria.
出版信息
Diagnostics (Basel). 2025 Jun 23;15(13):1592. doi: 10.3390/diagnostics15131592.
The course of treatment for renal artery stenosis following renal transplantation depends on the severity of the condition. Mild cases are typically managed medically, while more significant stenosis with flow limitation and graft dysfunction requires percutaneous intervention. Surgical treatment is generally reserved as a last resort. This study aimed to evaluate the outcomes of interventional radiology in managing renal artery stenosis at our transplant center. The electronic medical records of patients who underwent renal transplantation at our center between January 2020 and December 2024 were reviewed to identify cases of renal artery stenosis and their subsequent management through interventional radiology. Sociodemographic and clinical data were collected for both recipients and donors. Data analysis was performed using SPSS version 26. Out of the total 368 patients who received renal allograft at our center from January 2020 to December 2024, 25 patients were confirmed with duplex ultrasound to have renal artery stenosis. The majority of affected patients were African American, had Class I Obesity and presented with cardiovascular co-morbidities. The mean time from transplant to the diagnosis of RAS was 4.25 (SD ± 3.81) months. The mean serum creatinine level at presentation was 2.54 (SD ± 1.21 mg/dL). All 25 patients underwent digital subtraction angiography, and 24 patients were confirmed to have renal artery stenosis requiring further intervention. The creatinine levels at one week, three months and one year post-intervention were 2.12 (SD ± 1.00), 1.83 (SD ± 0.63) and 2.15 (SD ± 1.68) mg/dL, respectively. Percutaneous interventional treatment for renal artery stenosis is associated with improvements in hemodynamic parameters and the stabilization of allograft function. Follow-up is needed to monitor for the potential occurrence of restenosis.
肾移植后肾动脉狭窄的治疗方案取决于病情的严重程度。轻度病例通常采用药物治疗,而狭窄程度较重且伴有血流受限和移植肾功能障碍的情况则需要进行经皮介入治疗。手术治疗一般留作最后手段。本研究旨在评估在我们的移植中心采用介入放射学方法治疗肾动脉狭窄的效果。回顾了2020年1月至2024年12月期间在我们中心接受肾移植患者的电子病历,以确定肾动脉狭窄病例及其随后通过介入放射学进行的治疗。收集了受者和供者的社会人口统计学和临床数据。使用SPSS 26版进行数据分析。在2020年1月至2024年12月期间在我们中心接受同种异体肾移植的368例患者中,有25例经双功超声证实存在肾动脉狭窄。大多数受影响患者为非裔美国人,患有I级肥胖症,并伴有心血管合并症。从移植到诊断为肾动脉狭窄的平均时间为4.25(标准差±3.81)个月。就诊时的平均血清肌酐水平为2.54(标准差±1.21mg/dL)。所有25例患者均接受了数字减影血管造影,其中24例被证实存在需要进一步干预的肾动脉狭窄。干预后1周、3个月和1年时的肌酐水平分别为2.12(标准差±1.00)、1.83(标准差±0.63)和2.15(标准差±1.68)mg/dL。经皮介入治疗肾动脉狭窄与血流动力学参数改善和移植肾功能稳定相关。需要进行随访以监测再狭窄的潜在发生情况。