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Renal artery stenosis in pediatric transplant recipients

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Abstract

From 1967 through 1985, 400 cadaveric transplants were performed at Children Hospital of Los Angeles. Of these 400, 31 were later identified as having renal artery stenosis. No live related graft developed RAS. Of the 31 grafts, 11 were from donors less than 2 years of age. The major feature suggesting stenosis was hypertension: either persistent or a sudden exacerbation often associated with hypertensive encephalopathy. In individuals with hypertension without obvious cause, renal angiography should be promptly conducted under controlled conditions to avoid complications. The stenotic lesion involved 13 end-to-end and 19 end-to-side arterial anastomoses. Surgery for revascularization of RAS was performed in 21 of 31 with success or improvement in 14, no change in 2, and graft loss in 5. Percutaneous transluminal angioplasty was performed in 4. Two were unsuccessful, 1 was successful and 1 graft was lost. The 7 remaining patients were treated medically.

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References

  1. Leary FL, Woods JE, VeWeerd JH (1975) Urologic problems in renal transplantation. Arch Surg 110: 1124–1126

    Google Scholar 

  2. Kaufman JJ, Ehrlich RM, Dornfeld L (1976) Immunologic considerations in renovascular hypertension. J Urol 116: 142–147

    Google Scholar 

  3. Cameron JS, Turner DR (1977) Recurrent glomerulonephritis in allografted kidney. Clin Nephrol 7: 47–54

    Google Scholar 

  4. Whelton PK, Russell RP, Harrington DP, Williams GM, Walker WG (1979) Hypertension following renal transplantation. JAMA 241: 1128–1131

    Google Scholar 

  5. Curtis JJ (1985) Hypertension: a common problem for kidney transplant patients. Kidney Int 18: 5–8

    Google Scholar 

  6. Curtis JJ, Luke RG, Jones P, Diethelm AG, Whelchel JD (1985) Hypertension after successful renal transplantation. Am J Med 79: 193–200

    Google Scholar 

  7. Waltzer WC, Turner S, Frohnert P, Rapoport FT (1986) Etiology and pathogenesis of hypertension following renal transplantation. Nephron 42: 102–109

    Google Scholar 

  8. Canadian Multicentre Transplant Group (1983) A randomized clinical trial of cyclosporine in cadaveric renal transplantation. N Engl J Med 309: 809–815

    Google Scholar 

  9. LaCombe M (1975) Arterial stenosis complicating renal allotransplantation in man: a study of 38 cases. Ann Surg 181: 283–288

    Google Scholar 

  10. Ricotta JJ, Schaff HV, Williams GM, Rolley RT, Whelton PK, Harrington DM (1978) Renal artery stenosis following transplantation: etiology, diagnosis, and prevention. Surgery 84: 595–602

    Google Scholar 

  11. Rijksen JFWB, Koolen MI, Walaszewski JE, Terpstra JL, Vink M (1982) Vascular complications in 400 consecutive renal allografts. J Cardiovasc Surg (Torino) 23: 91–98

    Google Scholar 

  12. Jordan ML, Cook GT, Cardella CJ (1982) Ten years of experience with vascular complications in renal transplantation. J Urol 128: 689–692

    Google Scholar 

  13. Tilney NL, Rocha A, Strom TB, Kirkman RL (1984) Renal artery stenosis in transplant patients. Ann Surg 199: 454–460

    Google Scholar 

  14. Najarian JS, Simmons RL, Tallent MG (1971) Renal transplantation in infants and children. Ann Surg 174: 583–593

    Google Scholar 

  15. Boulton Jones JM, Cameron JS, Bewick M, Ogg CS, Meadow SR, Ellis FG (1971) Treatment of terminal renal failure in children by home dialysis and transplantation. Arch Dis Childh 46: 457–464

    Google Scholar 

  16. Malekzadeh MH, Brennan LP, Payne VC, Fine RN (1975) Hypertension after renal transplantation in children. J Pediatr 86: 370–375

    Google Scholar 

  17. Barth KH, Brusilow SW, Kaufman SL, Ferry FT (1981) Percutaneous transluminal angioplasty of homograft renal artery stenosis in a 10 year old girl. Pediatrics 67: 675–677

    Google Scholar 

  18. Lum CT, Fryd DS, Polta PA, Najarian JS (1982) Results of kidney transplantation in the young child. Transplantation 34: 167–171

    Google Scholar 

  19. Tejani A (1983) Post-transplant hypertension and hypertensive encephalopathy in renal allograft recipients. Nephron 34: 73–78

    Google Scholar 

  20. Trompeter RS, Haycock GB, Bewick M, Chantler C (1983) Renal transplantation in very young children. Lancet 1: 373–375

    Google Scholar 

  21. Ingelfinger JR (1984) Hypertension in children with ESRD. In: Fine RN, Gruskin AB (eds) End stage renal disease in children. W. B. Saunders, Philadelphia, pp 340–358

    Google Scholar 

  22. Gagnadoux MF, Niaudet P, Bacri JL, Antignac C, Broyer M (1985) Captopril and transplant renal artery stenosis in children. Transplant Proc 17: 187–188

    Google Scholar 

  23. Najarian JS, Ascher NL, Mauer SM (1986) Kidney transplantation. In: Welch KJ, Randolph JG, Ravitch MM, O'Neill JA Jr, Rowe MI (eds) Pediatric surgery, 4th edn. Yearbook, Chicago, pp 360–373

    Google Scholar 

  24. Simmons RL, Kjellstrand CM, Najarian JS (1972) Kidney. II. Technique, complications and results. In: Najarian JS, Simmons RL (eds) Transplantation. Lea and Febiger, Philadelphia p 452

    Google Scholar 

  25. Fine RN, Edelbrock HH, Riddell H, Malekzadeh MH, Pennisi AJ, Korsch BM (1977) Renal transplantation in children. Urology 9: 61–71

    Google Scholar 

  26. Fine RN, Malekzadeh MH, Pennisi AJ, Ettenger RB, Uittenbogaart CH (1978) Long term results of renal transplantation in children. Pediatrics 61: 641–650

    Google Scholar 

  27. Porstmann W (1970) Renal angiography in children. Prog Pediatr Radiol 3: 51–81

    Google Scholar 

  28. Grossman RA, Dafoe DC, Shoenfeld RB, Ring EJ, McLean GK, Oleaga JA, Freiman DB, Naji A, Perloff LJ, Barker CF (1982) Percutaneous transluminal angioplasty treatment of renal transplant artery stenosis Transplantation 34: 339–343

    Google Scholar 

  29. Margules RM, Belzer FO, Kountz SL (1973) Surgical correction of renovascular hypertension following renal allotransplantation. Arch Surg 106: 13–16

    Google Scholar 

  30. Schacht RA, Martin DG, Karalakulasingam R, Wheeler CS, Lansing AM (1976) Renal artery stenosis after renal transplantation. Am J Surg 131: 653–657

    Google Scholar 

  31. Beachley MC, Pierce JC, Boykin JV, Lee HM (1976) Angiographic evaluation of human renal allotransplants. Arch Surg 111:134–142

    Google Scholar 

  32. Kauffman HM, Sampson D, Fox PS, Doyle TJ, Maddison FE (1977) Prevention of transplant renal artery stenosis. Surgery 81: 161–167

    Google Scholar 

  33. Lindsey ES, Garbus SB, Golladay ES, McDonald JC (1974) Hypertension due to renal artery stenosis in transplanted kidneys. Ann Surg 181: 604–610

    Google Scholar 

  34. Serrallach N, Serrate R, Franco E, Munoz J, Aguilo F, Gutierrez R, Rius G, Montana X, Marco-Luque M, Cairols MA, Grino J (1985) Renal artery stenosis in transplanted kidney: management and results in six patients. Eur Urol 11: 31–35

    Google Scholar 

  35. Simmons RL, Tallent MB, Kjellstrand CM, Najarian JS (1970) Renal allograft rejection simulated by arterial stenosis. Surgery 68: 800–804

    Google Scholar 

  36. Schramek A, Adler O, Hashmonai M, Better OS, Tuma S, Barzilai A, Chaimowitz C (1975) Hypertensive crisis, erythrocytosis, and uraemia due to renal artery stenosis of kidney transplants. Lancet II: 70

    Google Scholar 

  37. Martin LW, Noseworthy J (1984) Surgical aspects of transplantation: technique and complications. In: Fine RN, Gruskin AB (eds) End stage renal disease in children. WB Saunders, Philadelphia, pp 458–472

    Google Scholar 

  38. Morris PJ, Yadav RVS, Kincaid-Smith P, Anderton J, Hare WSC, Johnson N, Johnson W, Marschall VC (1971) Renal artery stenosis in renal transplantation. Med J Austr 1: 1255–1257

    Google Scholar 

  39. Smith RB, Cosimi AB, Lordon R, Thompson AL, Ehrlich RM (1976) Diagnosis and management of arterial stenosis causing hypertension after successful renal transplantation. J Urol 115: 639–642

    Google Scholar 

  40. Smith RB, Ehrlich RM (1976) The surgical complications of renal transplantation. Urol Clin North Am 3: 621–646

    Google Scholar 

  41. Grunfeld JP, Kelinkrech TD, Moreau JF, Kamoun P, Sabto J, Garcia-Torres R, Osorio M, Kreis H (1975) Permanenet hypertension after renal homotransplantation in man. Clin Sci Mol Med 480: 391–403

    Google Scholar 

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Authors and Affiliations

  1. Divison of Nephrology, Childrens Hospital of Los Angeles, P. O. Box 54700, 90054, Los Angeles, CA, USA

    Mohammed Malekzadeh, Carl M. Grushkin & Ellin Lieberman

  2. Department of Radiology, Childrens Hospital of Los Angeles, P. O. Box 54700, 90054, Los Angeles, CA, USA

    Phillip Stanley

  3. Division of General Surgery, Childrens Hospital of Los Angeles, P. O. Box 54700, 90054, Los Angeles, CA, USA

    L. Patrick Brennan

  4. Division of Thoracic Surgery, Childrens Hospital of Los Angeles, P. O. Box 54700, 90054, Los Angeles, CA, USA

    Quentin R. Stiles

Authors
  1. Mohammed Malekzadeh
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  2. Carl M. Grushkin
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  3. Phillip Stanley
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  4. L. Patrick Brennan
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  5. Quentin R. Stiles
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  6. Ellin Lieberman
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Malekzadeh, M., Grushkin, C.M., Stanley, P. et al. Renal artery stenosis in pediatric transplant recipients. Pediatr Nephrol 1, 22–29 (1987). https://doi.org/10.1007/BF00866880

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  • DOI: https://doi.org/10.1007/BF00866880

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