Vascular complications in 237 recipients of renal transplant from cadaver
Agüera Fernández LG, Isa WA, Sánchez de la Muela PL, Rosell D, de Castro F, Robles JE, Errasti P, Berian JM.
Between July 1976 and June 1990, 244 transplantations were performed.
Of the 237 patients monitored, 13 (5.4%) had vascular complications: 10 (77%) renal artery stenosis, 1 (7.7%) primitive iliac artery stenosis, 1(7.7%) renal artery thrombosis, 1 (7.7%) renal vein thrombosis. Six patients underwent surgery (Angioplasty was performed in three patients, re-anastomosis to the common iliac artery in one, by-pass of saphenous vein in another one, while in the last one it was tried a release of the vascular pediculus). Management with drugs was possible in one case.
At present, 11 of the 13 patients are still alive and three of the grafts remain functional after a mean follow-up time of 83 months. According to a univariate study, the influential factors in the development of vascular complications are, the identity of Locus A, the type of extraction in Locus B, the length of cold ischaemia, the type of vascular anastomosis and the number of previous rejections.
The factors with maximal influence in the development of complications are the type of vascular suture (with or without patch) and the number of previous rejections (according to a study of log regression models).
The study demonstrates the significant influence vascular complications have on the graft's durability (p = 0.005).
CITATION Actas Urol Esp. 1992 Apr;16(4):292-5