Abstract
In previous studies with different donor selection criteria and noncontemporary surgical techniques, graft arterial stenosis (GAS) has been reported to occur more frequently in adult recipients of pediatric en bloc renal allografts (EBKT) as compared to single adult donor allografts. The purpose of our study was to evaluate the incidence of GAS within our EBKT recipient population and to evaluate clinical and imaging features of those cases with GAS. In a retrospective cohort study, we analyzed 182 EBKT performed at a single institution. We identified cases of suspected GAS based on clinical factors, lab results, and noninvasive imaging. Diagnosis of GAS was confirmed by digital subtraction angiography. Two EBKT recipients (1.1% of 182) had angiographically confirmed GAS at 2.5 and 4.5 months after transplant. In both cases, the stenoses were short segment within the proximal (perianastomotic) donor aorta, color Doppler ultrasound demonstrated peak systolic velocities of >400-cm/s, and poststenotic parvus tardus waveforms were present. Both patients underwent angioplasty and demonstrated postintervention improvement in renal function and blood pressure. Restenosis did not occur during follow up. In conclusion, recipients of EBKT have a low incidence of GAS, similar to the lowest reported for adult single allografts. The authors perform a retrospective analysis of recipients of pediatric kidney en bloc grafts for graft arterial stenosis to determine the incidence of stenosis in this population as well as the role of ultrasound in its diagnosis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2940-2946 |
| Number of pages | 7 |
| Journal | American Journal of Transplantation |
| Volume | 15 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2015 |
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ASJC Scopus subject areas
- Transplantation
- Immunology and Allergy
- Pharmacology (medical)
Cite this
Graft arterial stenosis in kidney en bloc grafts from very small pediatric donors : Incidence, timing, and role of ultrasound in screening. / Bent, C.; Fananapazir, Ghaneh; Tse, G.; Corwin, Michael T; Vu, Catherine T; Santhanakrishnan, Chandrase; Perez, Richard V; Troppmann, Christoph.
In: American Journal of Transplantation, Vol. 15, No. 11, 01.11.2015, p. 2940-2946.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Graft arterial stenosis in kidney en bloc grafts from very small pediatric donors
T2 - Incidence, timing, and role of ultrasound in screening
AU - Bent, C.
AU - Fananapazir, Ghaneh
AU - Tse, G.
AU - Corwin, Michael T
AU - Vu, Catherine T
AU - Santhanakrishnan, Chandrase
AU - Perez, Richard V
AU - Troppmann, Christoph
PY - 2015/11/1
Y1 - 2015/11/1
N2 - In previous studies with different donor selection criteria and noncontemporary surgical techniques, graft arterial stenosis (GAS) has been reported to occur more frequently in adult recipients of pediatric en bloc renal allografts (EBKT) as compared to single adult donor allografts. The purpose of our study was to evaluate the incidence of GAS within our EBKT recipient population and to evaluate clinical and imaging features of those cases with GAS. In a retrospective cohort study, we analyzed 182 EBKT performed at a single institution. We identified cases of suspected GAS based on clinical factors, lab results, and noninvasive imaging. Diagnosis of GAS was confirmed by digital subtraction angiography. Two EBKT recipients (1.1% of 182) had angiographically confirmed GAS at 2.5 and 4.5 months after transplant. In both cases, the stenoses were short segment within the proximal (perianastomotic) donor aorta, color Doppler ultrasound demonstrated peak systolic velocities of >400-cm/s, and poststenotic parvus tardus waveforms were present. Both patients underwent angioplasty and demonstrated postintervention improvement in renal function and blood pressure. Restenosis did not occur during follow up. In conclusion, recipients of EBKT have a low incidence of GAS, similar to the lowest reported for adult single allografts. The authors perform a retrospective analysis of recipients of pediatric kidney en bloc grafts for graft arterial stenosis to determine the incidence of stenosis in this population as well as the role of ultrasound in its diagnosis.
AB - In previous studies with different donor selection criteria and noncontemporary surgical techniques, graft arterial stenosis (GAS) has been reported to occur more frequently in adult recipients of pediatric en bloc renal allografts (EBKT) as compared to single adult donor allografts. The purpose of our study was to evaluate the incidence of GAS within our EBKT recipient population and to evaluate clinical and imaging features of those cases with GAS. In a retrospective cohort study, we analyzed 182 EBKT performed at a single institution. We identified cases of suspected GAS based on clinical factors, lab results, and noninvasive imaging. Diagnosis of GAS was confirmed by digital subtraction angiography. Two EBKT recipients (1.1% of 182) had angiographically confirmed GAS at 2.5 and 4.5 months after transplant. In both cases, the stenoses were short segment within the proximal (perianastomotic) donor aorta, color Doppler ultrasound demonstrated peak systolic velocities of >400-cm/s, and poststenotic parvus tardus waveforms were present. Both patients underwent angioplasty and demonstrated postintervention improvement in renal function and blood pressure. Restenosis did not occur during follow up. In conclusion, recipients of EBKT have a low incidence of GAS, similar to the lowest reported for adult single allografts. The authors perform a retrospective analysis of recipients of pediatric kidney en bloc grafts for graft arterial stenosis to determine the incidence of stenosis in this population as well as the role of ultrasound in its diagnosis.
UR - http://www.scopus.com/inward/record.url?scp=84945455250&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84945455250&partnerID=8YFLogxK
U2 - 10.1111/ajt.13365
DO - 10.1111/ajt.13365
M3 - Article
C2 - 26153092
AN - SCOPUS:84945455250
VL - 15
SP - 2940
EP - 2946
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 11
ER -