al-Najjar A, Halimi J M, Buchler M, Birmelé B, Tranquart F, Alison D, Lebranchu Y
Service de néphrologie-transplantation et immunologie clinique, CHU Tours.
Arch Mal Coeur Vaiss. 1998 Aug;91(8):1073-6.
We assessed the long-term (M +/- SE: 68 +/- 3 months) arterial pressure and renal function of cadaveric kidney transplant recipients with and without significant (> 70% diameter reduction) transplant renal artery stenosis (TRAS) at angiography. Baseline clinical, immunological and outcome data for 26 patients with TRAS (incidence of TRAS: 6.6%) before and following angioplasty and 72 patients without stenosis at angiography were reviewed and analyzed. The 2 groups were similar with respect to recipient sex ratio and age (45 vs 46), duration of transplantation (7 months), cause of renal failure, donor sex and age, HLA-antigen mismatches and titers of anti-HLA antibodies, CMV infection and anti-CMV antibodies in donors and recipients. The technical success of angioplasty was 92.3%. Restenosis was documented in 6/26 patients (23.1%). Revascularization resulted in a decrease of arterial pressure and number of antihypertensive medications and a lower serum creatinine compared to baseline values. The long-term arterial pressure and serum creatinine levels were similar in patients with and without stenosis. In conclusion, TRAS after revascularization had no detectable influence on the long-term arterial pressure control and renal function within a follow-up period of 68 +/- 3 months.
我们评估了尸体肾移植受者在血管造影时有无显著（直径缩小>70%）移植肾动脉狭窄（TRAS）情况下的长期（均值±标准误：68±3个月）动脉血压和肾功能。回顾并分析了26例TRAS患者（TRAS发生率：6.6%）血管成形术前和术后以及72例血管造影无狭窄患者的基线临床、免疫学和结局数据。两组在受者性别比和年龄（45对46）、移植持续时间（7个月）、肾衰竭病因、供者性别和年龄、HLA抗原错配以及抗HLA抗体滴度、巨细胞病毒（CMV）感染以及供者和受者的抗CMV抗体方面相似。血管成形术的技术成功率为92.3%。6/26例患者（23.1%）记录到再狭窄。与基线值相比，血运重建使动脉血压和抗高血压药物数量降低，血清肌酐水平下降。有狭窄和无狭窄患者的长期动脉血压和血清肌酐水平相似。总之，在68±3个月的随访期内，血运重建后的TRAS对长期动脉血压控制和肾功能无明显影响。
