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2018 ; 2018
(ä): 2580181
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gab.com Text
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English Wikipedia
Standardized Duplex Ultrasound-Based Protocol for Early Diagnosis of Transplant
Renal Artery Stenosis: Results of a Single-Institution Retrospective Cohort
Study
#MMPMID29850493
Li Marzi V
; Campi R
; Sessa F
; Pili A
; Vignolini G
; Gacci M
; Marzocco M
; Dattolo E
; Minetti E
; Santini M
; Gatti M
; Peris A
; Serni S
Biomed Res Int
2018[]; 2018
(ä): 2580181
PMID29850493
show ga
Transplant renal artery stenosis (TRAS) is the most frequent vascular
complication after kidney transplantation (KT) and has been associated with
potentially reversible refractory hypertension, graft dysfunction, and reduced
patient survival. The aim of the study is to describe the outcomes of a
standardized Duplex Ultrasound- (DU-) based screening protocol for early
diagnosis of TRAS and for selection of patients potentially requiring
endovascular intervention. We retrospectively reviewed our prospectively
collected database of KT from January 1998 to select patients diagnosed with
TRAS. The follow-up protocol was based on a risk-adapted, dynamic subdivision of
eligible KT patients in different risk categories (RC) with different protocol
strategies (PS). Of 598 patients included in the study, 52 (9%) patients had
hemodynamically significant TRAS and underwent percutaneous angioplasty (PTA) and
stent placement. Technical and clinical success rates were 97% and 90%,
respectively. 7 cases of restenosis were recorded at follow-up and treated with
re-PTA plus stenting. Both DU imaging and clinical parameters improved after
stent placement. Prospective high-quality studies are needed to test the efficacy
and safety of our protocol in larger series. Accurate trial design and
standardized reporting of patient outcomes will be key to address the current
clinical needs.