Incidence and Risk Factors of Transplant Renal Artery Stenosis in Living Unrelated Donor Renal Transplantation

BACKGROUND: This study was designed to evaluate the incidence and risk factors of transplant renal artery stenosis (TRAS) among living donor unrelated kidney recipients. PATIENTS AND METHODS: Three hundred and sixty kidney consecutive transplant recipients were included in this retrospective cohort study. Informed written consent was obtained, only TRAS occurring three months after transplantation were considered. After five-year follow up, TRAS was established in 6.6% (24 patients) of patients. RESULTS: Mean +/- SD age of recipients was 39.8 +/- 14.9 years old (range 16-77). Upon multivariate analysis recipient age >50 (RR = 2.9, CI 95%: 1.33-2.93, p = 0.008), recipient BMI >30 (kg/m(2)) (RR: 7.97, CI 95%: 3.44-18.46, p < 0.001), retransplantation (RR = 4.88, CI 95%: 2.21-10.77, p < 0.001), cytomegalovirus (CMV) infection and delayed graft function (DGF) (RR: 4.29, CI 95%: 3.12-13.79, p = 0.01) appeared to be independently associated with TRAS. Positive CMV-antibody was more frequent in recipients with TRAS (95.83% vs. 70.8%, p = 0.04) but all of them were HCV-antibody negative. Other variables as discussed were similar between two groups. CONCLUSION: High recipient age, BMI > 30, hyper trigelyceridaemia, previous transplantation, CMV infection and DGF are shown to be risk factors for TRAS.