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Ultrasound
Diagnosis
Kidney
Kidney Transplant Complications
Transplant Renal Artery Stenosis
Transplant Renal Artery Stenosis
Jade Wong-You-Cheong, MBChB, MRCP, FRCR, FSRU, FSAR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Transplant renal artery stenosis (TRAS)

          • Definitions

            • Narrowing of transplant renal artery (TRA)

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • Nuclear Medicine Findings

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Hasjim BJ et al: Utilization of carbon dioxide angiography and percutaneous balloon angioplasty for treatment of transplant renal artery stenosis. Ann Vasc Surg. 65:10-6, 2020
                                            2. Bull AS et al: Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys. Int Braz J Urol. 45(5):925-31, 2019
                                            3. Sugi MD et al: Imaging of renal transplant complications throughout the life of the allograft: comprehensive multimodality review. Radiographics. 39(5):1327-55, 2019
                                            4. Fananapazir G et al: Vascular complications in kidney transplant recipients. Abdom Radiol (NY). 43(10):2546-54, 2018
                                            5. Fananapazir G et al: Screening for transplant renal artery stenosis: ultrasound-based stenosis probability stratification. AJR Am J Roentgenol. 209(5):1064-73, 2017
                                            6. Chen W et al: Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy. Clin Kidney J. 8(1):71-8, 2015
                                            7. Gaddikeri S et al: Comparing the diagnostic accuracy of contrast-enhanced computed tomographic angiography and gadolinium-enhanced magnetic resonance angiography for the assessment of hemodynamically significant transplant renal artery stenosis. Curr Probl Diagn Radiol. 43(4):162-8, 2014
                                            8. Rodgers SK et al: Ultrasonographic evaluation of the renal transplant. Radiol Clin North Am. 52(6):1307-24, 2014
                                            9. Glebova NO et al: Endovascular interventions for managing vascular complication of renal transplantation. Semin Vasc Surg. 26(4):205-12, 2013
                                            10. Kobayashi K et al: Interventional radiologic management of renal transplant dysfunction: indications, limitations, and technical considerations. Radiographics. 27(4):1109-30, 2007
                                            11. Li JC et al: Evaluation of severe transplant renal artery stenosis with Doppler sonography. J Clin Ultrasound. 33(6):261-9, 2005
                                            12. de Morais RH et al: Duplex Doppler sonography of transplant renal artery stenosis. J Clin Ultrasound. 31(3):135-41, 2003
                                            13. Patel U et al: Doppler ultrasound for detection of renal transplant artery stenosis-threshold peak systolic velocity needs to be higher in a low-risk or surveillance population. Clin Radiol. 58(10):772-7, 2003
                                            14. Loubeyre P et al: Transplanted renal artery: detection of stenosis with color Doppler US. Radiology. 203(3):661-5, 1997
                                            15. Baxter GM et al: Colour Doppler ultrasound in renal transplant artery stenosis: which Doppler index? Clin Radiol. 50(9):618-22, 1995
                                            16. Gottlieb RH et al: Diagnosis of renal artery stenosis in transplanted kidneys: value of Doppler waveform analysis of the intrarenal arteries. AJR Am J Roentgenol. 165(6):1441-6, 1995
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Transplant renal artery stenosis (TRAS)

                                                    • Definitions

                                                      • Narrowing of transplant renal artery (TRA)

                                                    IMAGING

                                                    • General Features

                                                      • Ultrasonographic Findings

                                                        • Nuclear Medicine Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Angiographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Hasjim BJ et al: Utilization of carbon dioxide angiography and percutaneous balloon angioplasty for treatment of transplant renal artery stenosis. Ann Vasc Surg. 65:10-6, 2020
                                                                                      2. Bull AS et al: Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys. Int Braz J Urol. 45(5):925-31, 2019
                                                                                      3. Sugi MD et al: Imaging of renal transplant complications throughout the life of the allograft: comprehensive multimodality review. Radiographics. 39(5):1327-55, 2019
                                                                                      4. Fananapazir G et al: Vascular complications in kidney transplant recipients. Abdom Radiol (NY). 43(10):2546-54, 2018
                                                                                      5. Fananapazir G et al: Screening for transplant renal artery stenosis: ultrasound-based stenosis probability stratification. AJR Am J Roentgenol. 209(5):1064-73, 2017
                                                                                      6. Chen W et al: Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy. Clin Kidney J. 8(1):71-8, 2015
                                                                                      7. Gaddikeri S et al: Comparing the diagnostic accuracy of contrast-enhanced computed tomographic angiography and gadolinium-enhanced magnetic resonance angiography for the assessment of hemodynamically significant transplant renal artery stenosis. Curr Probl Diagn Radiol. 43(4):162-8, 2014
                                                                                      8. Rodgers SK et al: Ultrasonographic evaluation of the renal transplant. Radiol Clin North Am. 52(6):1307-24, 2014
                                                                                      9. Glebova NO et al: Endovascular interventions for managing vascular complication of renal transplantation. Semin Vasc Surg. 26(4):205-12, 2013
                                                                                      10. Kobayashi K et al: Interventional radiologic management of renal transplant dysfunction: indications, limitations, and technical considerations. Radiographics. 27(4):1109-30, 2007
                                                                                      11. Li JC et al: Evaluation of severe transplant renal artery stenosis with Doppler sonography. J Clin Ultrasound. 33(6):261-9, 2005
                                                                                      12. de Morais RH et al: Duplex Doppler sonography of transplant renal artery stenosis. J Clin Ultrasound. 31(3):135-41, 2003
                                                                                      13. Patel U et al: Doppler ultrasound for detection of renal transplant artery stenosis-threshold peak systolic velocity needs to be higher in a low-risk or surveillance population. Clin Radiol. 58(10):772-7, 2003
                                                                                      14. Loubeyre P et al: Transplanted renal artery: detection of stenosis with color Doppler US. Radiology. 203(3):661-5, 1997
                                                                                      15. Baxter GM et al: Colour Doppler ultrasound in renal transplant artery stenosis: which Doppler index? Clin Radiol. 50(9):618-22, 1995
                                                                                      16. Gottlieb RH et al: Diagnosis of renal artery stenosis in transplanted kidneys: value of Doppler waveform analysis of the intrarenal arteries. AJR Am J Roentgenol. 165(6):1441-6, 1995