Abstract:
Vascular complications after renal transplantation are one of the serious surgical complications, which can affect the transplantation outcome and even endanger life if not treated properly. We performed a retrospective analysis of the 2,304 renal transplantations procedures completed between the period of Jan., 2015 and Jan., 2022, which consisted of 1,658 male patients and 646 female patients. Among the above cases, there were 54 cases of vascular complications after renal transplantation, the incidence of vascular complications in our study was 2.34% (54/2,304), the most common vascular complication was transplanted renal artery stenosis (TRAS, n = 36), followed by external iliac artery dissection (n = 5), renal artery rupture (n = 4), renal vein thrombosis (n = 3), renal artery thrombosis (n = 2), renal artery dissection (n = 1), renal artery pseudoaneurysm (n = 1), and internal iliac artery pseudoaneurysm (n = 1), and renal artery kinking (n = 1). 40 patients were treated by percutaneous transluminal angioplasty (PTA), including 3 balloon catheter dilatation and 37 endovascular stentings, and 14 underwent open surgery. Eventually, 9 patients had graft nephrectomy, resulting in an overall treatment rate of 81.5%. Most vascular complications can be treated satisfactorily with PTA. However, the overall treatment of renal artery rupture, thrombosis, renal artery kinking, and other complications is poor, and the rate of transplanted renal loss is high.
摘要:
血管并发症是肾移植术后严重的手术并发症之一,如果治疗不当,可能会影响移植结果,甚至危及生命。我们对1月之间完成的2,304例肾移植手术进行了回顾性分析,2015年1月,2022年,共有1658名男性患者和646名女性患者。在上述情况中,肾移植术后有54例血管并发症,我们研究中血管并发症的发生率为2.34%(54/2,304),最常见的血管并发症是移植肾动脉狭窄(TRAS,n=36),其次是髂外动脉夹层(n=5),肾动脉破裂(n=4),肾静脉血栓形成(n=3),肾动脉血栓形成(n=2),肾动脉夹层(n=1),肾动脉假性动脉瘤(n=1),髂内动脉假性动脉瘤(n=1),和肾动脉扭结(n=1)。40例患者行经皮腔内血管成形术(PTA),包括3个球囊导管扩张和37个血管内支架,14人接受了开放手术。最终,9例患者进行了移植肾切除术,总体治疗率为81.5%。PTA可以令人满意地治疗大多数血管并发症。然而,肾动脉破裂的整体治疗,血栓形成,肾动脉扭结,其他并发症很差,移植肾损失率高。