Post-Transplant Vascular Complications In Kidney Transplant Recipients
Özet
Vascular complications after kidney transplantation are relatively uncommon but may have a major impact on graft survival and patient morbidity. These complications involve the graft arterial inflow, graft venous outflow, or recipient iliac vessels, and may present in the early or late post-transplant period. Their mechanisms are multifactorial and commonly reflect varying contributions of vessel wall injury, disturbed flow, and thrombotic predisposition. Among them, transplant renal artery stenosis is the most frequent vascular complication and is often amenable to endovascular or surgical treatment, whereas arterial and venous thrombosis remain major causes of early graft loss. Biopsy-related arteriovenous fistulae and intrarenal pseudoaneurysms are usually benign but may require intervention in selected patients. Mechanical lesions such as arterial kinking, venous compression, and iliac vessel pathology should also be recognized, as delayed diagnosis may result in irreversible graft injury. This chapter reviews the classification, mechanisms, risk determinants, clinical presentation, imaging findings, and treatment principles of the major vascular complications after kidney transplantation, with emphasis on practical diagnostic reasoning and timely management.
Referanslar
Blichová T, Kleinová P, Vnučák M, et al. Surgical complications after kidney transplantation. Ann Transplant. 2025;30:e948531.
de Boer SE, Knobbe TJ, Kremer D, et al. Kidney transplantation improves health-related quality of life in older recipients. Transpl Int. 2024;37:12071.
White-Dzuro CE, Geanon DJ, Fagel BM, et al. Vascular and lymphatic complications after renal transplant. Abdom Radiol (NY). 2025;50(12):6085-6105.
Verloh N, Doppler M, Hagar MT, et al. Interventional management of vascular complications after renal transplantation. Rofo. 2023;195(6):495-504.
Gunawardena T. Update on vascular complications after renal transplantation. Exp Clin Transplant. 2022;20(4):333-341.
El Zorkany K, Bridson JM, Sharma A, et al. Transplant renal vein thrombosis. Exp Clin Transplant. 2017;15(2):123-129.
Tamara F, Fajar JK, Gersom C, et al. Global prevalence and contributing factors of transplant renal artery stenosis in renal transplant recipients: a systematic review and meta-analysis. Narra J. 2024;4(3):e1782.
Pini A, Faggioli G, Pini R, et al. Assessment and management of transplant renal artery stenosis: a literature review. Ann Vasc Surg. 2022;82:13-29.
Mirza A, Baig U, Khan M, et al. Clinical utility of duplex ultrasonography in the recognition of transplant renal artery stenosis: a single-center experience. Diagnostics (Basel). 2025;15(14):1766.
Costa Silva A, Pina-Vaz T, Pinho A, et al. Vascular complications following kidney transplantation from uncontrolled donation after circulatory death: a prospective study. Clin Transplant. 2025;39(12):e70417.
Stigler J, Tiefenthaler M. Value and limitations of sonography in kidney transplant recipients with special attention to the resistive index: an update. Front Nephrol. 2022;2:997839.
Uchida N, Miyajima K, Yanagiswa T, et al. Transplant renal vein thrombosis and stenosis rescued by interventional radiology. IJU Case Rep. 2024;7(5):387-390.
Anders L, Stephens R, Laub M, et al. Management of transplant renal artery pseudoaneurysm and literature review. Case Rep Transplant. 2022;2022:6232586.
Konopa J, Komorowska-Jagielska K, Łaski D, et al. Kidney transplant loss due to May-Thurner syndrome: case report and review of the literature. Transplant Proc. 2024;56(4):972-975.
Granata A, Clementi S, Londrino F, et al. Renal transplant vascular complications: the role of Doppler ultrasound. J Ultrasound. 2014;18(2):101-107.
