Background:Transplant Renal Artery Stenosis (TRAS) is a low incidence complication, but if untreated, can lead to graft failure, refractory hypertension (HT) and reduced life expectancy. Primary stent implantation is a well-tolerated technique for TRAS treatment.Methods:The aim of this study was to assess the safety and efficiency of TRAS endovascular therapy. The primary end point was graft survival. The secondary end points were serum creatinine level, blood pressure evolution and the number os antihypertensive drugs pre- and post- procedure.We performed a retrospective single-institutional review of all cases of TRAS from January 2011 to April 2016.Results:From 519 renal transplants, 26percutaneous procedures have been performed on 24 patients (68% men, 88% with HT, mean age 50y).The median time to presentation was 169 days. Stenting was performed in all patients with 100% technical and clinical sucess. The major indications were acute graft dysfunction (54%) and poor function (25%); in addition to two cases of HT and three cases of delayed graft function (DGF). During a mean follow-up of 23 months, a reduction in SCr (Pre-procedure-3.05mg/dL 30 days-1.73mg/dL 60 days-1.62 mg/dL p<0,001) with 92% graft survival was shown.We found that recovering of renal function before 30 days was an independent predictor of graft survival. All DGF patients left hemodialysis after procedure. When HT was the indication for the procedure improved blood pressure parameters and reduction in the number of AHD, was also observed in other patients (2.09 x 1.50 p=0.008).In 2 cases restenosis was observed requiring new treatment. 2 patients died from unrelated causes to the procedure. Conclusions: The endovascular management with stent placement of TRAS is safe and presents a high of clinical sucess with low morbidity.Its impact on SCr is significant in our experience, being an effective procedure for restoring and maintaining the graf function.

CITATION INFORMATION: Cavalcanti A, Durao M, Santos B, Tonato E, Doher M, Guimaraes-Souza N, Moreira Valle L, Affonso B, Nasser F, Pacheco-Silva A. Endovascular Management of Transplant Renal Artery Stenosis: A Safe and Effective Treatment. Am J Transplant. 2017;17 (suppl 3).

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