Transplantatnierenarterienstenose: Perkutane transluminale Angioplastie als First-Line-Therapie
In our transplant centre 11 of 264 patients (4,17%) who underwent kidney transplantation were diagnosed with significant transplant renal artery stenosis. In addition to that, TRAS occurred in two elsewhere transplanted patients who had their follow-up examinations in our centre. Either a rise of the creatinine level or/and worsened systemic hypertension or routine examination with color doppler sonography were the indication to perform an angiography which was extended to percutaneous
... rcutaneous transluminal angioplasty after the diagnosis of TRAS was confirmed in all of these patients. The immediate success rate for PTA was 92,3% (12/13). Only one patient with a kinking of the renal artery had to undergo surgery to restore renal function. No complications occurred after the interventions. The patients were monitored for a mean observation time of 33,15 months. The creatinine levels were lower after the intervention (mostly significantly), the effect on blood pressure was immediate, but not long-lasting, whereas the dose of the prescribed drugs decreased within time. A rise of the hemoglobine level could also be seen. So the effect of the PTA is not only temporarily, but mostly long-lasting, which means it should be first-line treatment in TRAS except for kinking stenosis which should be treated by surgery.