Renal transplant arterial stenosis: amelioration of hypertension and improvement of transplant function after revascularization.

Two of 70 patients treated for a minimum of six months after renal transplantation developed main arterial stenosis to the allograft. Both underwent transplant revascularization and had follow-up at least six months to document lasting benefit. Amelioration of hypertension and improvement of transplant function proved statistically significant. Collateral vessels were not identified on pre-revascularization arteriographic studies. It is suggested that loss of the potential to develop protective collateral channels to transplanted kidneys mandates aggressive evaluation when hypertension and deteriorating renal function occur in the late follow-up period after renal transplantation. In such instances, arteriography and renin determinations may identify salvagable renal allografts, obviating necessity of subsequent retransplantation.