Our objective was to evaluate the usefulness of three-dimensional contrast enhanced MR angiography (3D CE MRA) for assessment of renal artery anastomosis in the early period after kidney transplantation.
Between January 2010 and February 2012, a consecutive series of 267 KTs was examined with 3D CE MRA 14 days after transplantation. The study recipients were divided into four groups by the degree of renal artery inflow stenosis qualitatively (group I: normal; group II: mild = <50%; group III: moderate = 50-70%; group IV: severe >70%). The following variables were compared: donor and recipient characteristics, multiplicity of renal arteries, the type of the arterial anastomosis [end-to-end anastomosed to IIA (internal iliac artery) or end-to-side anastomosed to EIA (external iliac artery)], post-operative renal function (mean creatinine levels at 14 days, 1 and 6 months, and 1 year), and graft survival.
216 (80.9%) of the 267 patients had normal 3D CE MRA, 29 (10.9%) showed mild, 8 (3.0%) was moderate, and 14 patients (5.2%) had severe stenosis of renal inflow. 11 patients of severe arterial stenosis on CE MRA underwent selective digital subtraction angiography (DSA). In ten patients, angioplasty or stenting was performed. The mean creatinine value at 14 days post-transplant (1.27± 0.48, 1.21±0.48, 1.04±0.32, 1.20± 0.27, respectively) did not significantly different among the four groups (P = 0.495). The prevalence of graft loss (n=2, 14.3%) was high in patients with severe arterial stenosis, but there was no significant differences in these groups (P = 0.118). In group IV, multiplicity of renal arteries (n=8, 57.1%) and the type of end-to-end arterial anastomosis (n=12, 85.7%) were much higher frequency (P = 0.026, P = 0.362, respectively) than other groups.
The incidence of arterial flow stenosis is unexpectedly high in the early period after kidney transplantation even if creatinine level was normal. So, 3D CE MRA allows rapid global assessment of renal transplant arterial system. It can also help detect or exclude many of the various causes of renal transplant dysfunction.
To cite this abstract in AMA style:Hwang J, Park S, Choi B, Chun H, Kim J, Yang C, Kim Y, Moon I. Transplant Renal Arterial Inflow Stenosis Defined by Contrast Enhanced MR Angiography and MR Imaging in Early Period after Renal Transplantation: Predisposing Factors and Clinical Outcomes [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/transplant-renal-arterial-inflow-stenosis-defined-by-contrast-enhanced-mr-angiography-and-mr-imaging-in-early-period-after-renal-transplantation-predisposing-factors-and-clinical-outcomes/. Accessed September 23, 2017.
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