Clinical Study On Transplant Renal Artery Stenosis

Background:Transplant renal artery stenosis (TRAS) is a common postransplant vascular complication and it is a important,potentially curable cause of posttransplant arterial hypertension,allograft dysfunction, and graft loss. It usually occurs from 3 months to 2 years after transplantation. Its incidence is still controversial .The prevalence of this disorder has varied in the literature, ranging from 1% to 23%. This discrepancy can be attributed to several factors. First, the definition of hemodynamically significant transplant renal arterial stenosis has not been standardized; investigators have used a range of narrowing of the arterial lumen from greater than 50% to greater than 80%.the ready availability of noninvasive screening modalities, Color Doppler Ultrasonography,for example. Last,varying surgical expertise and thinking highly of TRAS may also play a role.The cause of TRAS is controversial too.The intuitive presentation of TRAS is intimal hyperplasia of the donor arteries.Some of the factors potentially contributing to graft vasculopathy include histocompatibility mismatch,frequency and intensity of rejection episodes,ischaemia use of cyclosporine. Other factors suggested include atherosclerotic changes,faulty suture technique,renal artery trauma,perfusion injury,turbulent flow secondary to malpositioning of the kidney and kinking or compression of the artery.Many experimental and clinical data have suggested an...