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45 Renal Transplant Artery Stenosis: The Possible Association With Acute Rejection Episodes and Immunosuppressive Treatment
Author(s) -
Župunski A,
Kandus A,
Bren AF,
ButurovićPonikvar J
Publication year - 2005
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1526-0968.2005.222_45_45.x
Subject(s) - medicine , azathioprine , stenosis , transplantation , renal artery stenosis , methylprednisolone , surgery , creatinine , complication , renal function , gastroenterology , renal artery , kidney , disease
Background Renal transplant artery stenosis is a relatively frequent complication after transplantation and is a potentially correctable cause of hypertension and/or deterioration of renal function and graft loss. There were reports of the immunological mechanism playing a role in the pathogenesis of stenosis. Purpose The aim of our retrospective clinical study was to assess the association of renal transplant artery stenosis with the acute rejection episodes and immunosuppressive treatment. Methods Thirty‐four renal transplant recipients, 14 females and 20 males, aged 42.7 ± 13 years, were found to have significant (>50%) stenosis. In the control group there were 34 patients without stenosis, matching the patients from stenosis group for age, sex, year of transplantation, type of graft and number of previous grafts. Patients were followed for 3 years post‐transplant. Acute rejection episodes were diagnosed histologically. Results In the stenosis group 8/34 (23%) patients had 10 acute rejection episodes compared to 5/34 (15%) patients having 6 episodes in control group ( P = 0.353). In stenosis group 20/34 (59%) patients have received double (cyclosporine A and methylprednisolone), and 14/34 (41%) patients triple immunosuppressive treatment (cyclosporine A, methylprednisolone and azathioprine or mycophenolate mofetil), respectively. In the control group 28/34 (82%) patients have received double, and 6/34 (18%) patients triple immunosuppressive treatment, respectively ( P = 0.033). There were no significant differences in serum creatinine and blood pressure at 1, 2 and 3 years after transplantation between the groups. Conclusions There was a tendency towards higher number of acute rejection episodes in the stenosis group, however not statistically significant. Patients with stenosis have received more intensive immunosuppressive treatment.