1 Department of Transplant Surgery, 2 Department of Radiology and 3 Department of Nephrology, St James University Hospital, Beckett Street, Leeds, UK
Correspondence and offprint requests to: Mr Sandeep Guleria, Consultant Surgeon, Department of Organ Transplantation, Lincoln Wing, St James University Hospital, Beckett Street, Leeds LS9 7TF, UK. Email: sandeepguleria{at}hotmail.com
Keywords: arterial kinking; graft dysfunction; renal transplant
A 50-year-old man with end-stage renal failure due to adult polycystic kidney disease underwent a cadaveric renal transplant. The renal transplant was uneventful and the right kidney was transplanted into the right iliac fossa. There was a single artery, vein and ureter. The kidney reperfused well but there was no primary function.
In the first 24 h he only made 69 ml of urine and the serum creatinine climbed from 616 to 757 mmol/l. A Doppler ultrasound of the transplant kidney was undertaken and this revealed a tardus and parvus abnormality of prolonged acceleration time, diminished acceleration index and loss of the normal early systolic compliance peak/reflective wave complex [1]. A repeat ultrasound later showed the same abnormality with an increased velocity of the main transplant renal artery indicating a high-grade renal artery stenosis. An angiography demonstrated two kinks in the renal artery (Figure 1). The kinks were treated by two stents, 6 mm in diameter and 1.7 cm in length (Figure 2). The patient was heparinized for the next 24 h and then started on clopidogrel.
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Conflict of interest statement. None declared.
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