TN05 NATURAL HISTORY OF TRANSPLANT RENAL ARTERY STENOSIS.

Introduction Integrity of Transplant Renal Artery is crucial for long term survival of the graft. Literature regarding the evolution of Transplant Renal Artery Stenosis (TRAS) is scant. Method Retrospective analysis of 1042 duplex scans in kidney transplant recipients. Duplex scan (GE VIVID 307, multiphase transducer) was used as routine screening modality. Time period 1999–2006. Total no of patients −148. Mean age 47.4 yrs. M : F: 83 : 65. Average follow up −2.45 yrs. Renal arterial ratio and peak systolic velocities were used as absolute criteria for diagnosis. Relative criteria used were parenchymal perfusion, size of kidney, resistive indices and presence of other vascular conditions. Results Number of patients detected to have TRAS-50. Mean age- 48.36 yrs. M : F: 29 : 21. Average time period for detection of stenosis – 193 days. 20 patients had ostial stenosis, 23 – mid segment, 1 at hilum, 2 – branch and 4 – throughout length of artery. Two groups: Early stenosis i.e. within 3 mo – 36(72%) patients. Late stenosis – 14 (28%) patients. Average time to detect early stenosis 74 (10–100) days and late stenosis 502 (140–1396) days. 21/36 patients in group 1 showed complete resolution of stenosis in an average time of 270 days whereas only 3/14 patients in the late group resolved at an average period of 375 days (p = 0.019). Conclusion Routine duplex scans can detect significant numbers of TRAS. Stenosis occurring early post transplant are more likely to resolve than late occurring stenosis. Prospective controlled studies are needed to resolve the issue. [ABSTRACT FROM AUTHOR]