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      Unusual Cause of Early Graft Dysfunction after Kidney Transplantation

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          Background/Aims: Transplant renal artery stenosis usually develops in the later period after renal transplantation and is usually due to atherosclerosis and fibrosis at the anastomosis. A kinking renal artery stenosis, however, is a rare cause of early graft dysfunction. Methods: In a 34-year-old-man early graft failure developed within 1 week after kidney transplantation. In the presence of histologically proven ischemic damage an arterial kinking stenosis was diagnosed by color Doppler sonography. Selective arteriography confirmed the sharp kinking of the transplant renal artery; however, a significant stenosis could not be visualized by arteriography. Results: Due to progressive loss of renal function surgical resection of scar tissue in the kink of the transplant artery and nephropexy was performed. Immediately thereafter graft function and blood pressure significantly improved so that the successful clinical outcome of this unusual case of early graft failure confirmed the relevance of the arterial kinking stenosis. Conclusions: In this unusual case of early graft dysfunction relevant kinking renal artery stenosis could not be adequately visualized by arteriography, although color Doppler sonography clearly demonstrated the stenosis. Therefore, both methods should be considered if parenchymal causes of graft dysfunction are excluded by biopsy and a kinking renal artery stenosis is suspected.

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          Author and article information

          Am J Nephrol
          American Journal of Nephrology
          S. Karger AG
          June 1998
          06 May 1998
          : 18
          : 3
          : 237-239
          Departments of a Internal Medicine IV b Surgery, and c Diagnostic Radiology, University Hospital Freiburg, Germany
          13343 Am J Nephrol 1998;18:237–239
          © 1998 S. Karger AG, Basel

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          Page count
          Figures: 2, References: 9, Pages: 3
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/13343
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