Clinical analysis on 10 patients with artery complications after renal transplantation

Abstract

Objective To investigate the diagnosis and treatment of artery complications after operation in renal transplantation. Method A retrospective study was performed on the experiences and lessons about 10 patients with artery complications postoperation in renal transplantation. Result Hemorrhage occurred in 3 cases because the rupture of kidney graft artery. Two cases of kidney graft artery were infected due to aspergilluses and 1 due to bacteria. The diagnoses were confirmed by pathological examination. Three cases were returned to hemodialysis after the removal of kidney grafts and administration of anti-fungal agents and antiseptics. Four patients of transplant renal pseudoaneurysm were all single branch. The end-to-side anastomosis was done between renal artery and the external iliac artery. Two cases were found in the operation, external iliac arteries were repaired and renal function was normal. Two cases were found postoperation. Kidneys were removed and second perfusion was done. The kidneys were replanted with renal graft artery anastomosed to the internal iliac artery. Delayed graft function (DGF) occurred in 1 case, and one case recovered with normal allograft function. In one patient with kidney artery thrombosis, the embolus was taken out by emergent reoperation, and renal function had delayed recovery. Two cases of transplanted renal artery stensis were treated by balloon angioplasty and metallic stent placement via femoral artery, and renal function was normal so far. Conclusion Artery complication is uncommon but serious after renal transplantation. It would not only affect renal function, but were more likely to endanger the patient's life. Early diagnosis, emergency surgical exploration and initiation of specific treatment in addition to graft nephrectomy would get satisfied results. Key words: Kidney transplantation; Artery; Complications; Infections