Aims: To evaluate the progression of transplant renal vein stenosis (TRVS) in the early post-operative period and its impact on clinical outcomes.
Materials and methods: This prospective study enrolled 23 consecutive patients with TRVS detected by contrast-enhanced ultrasound (CEUS). Duplex ultrasound (DUS) was performed on days 1, 30, and 90 after transplantation. The DUS measurements included peak velocity (PV) of stenosis and peak velocity ratio of stenosis to pre-stenosis (PV-ratio). The differences in DUS measurements across different timepoints were evaluated by linear mixed-effects model.
Results: The mean serum creatinine (SCr) levels at days 30 and 90 were 131 (range, 46 - 196) μmol/L, and 103 (range, 70 - 136) μmol/L, respectively. Two TRVS cases were caused by mural thrombi, the remaining 21 cases were free of any surgical complications. The mean TRVS-PV at days 1, 30, and 90 were 335 ± 92, 221 ± 86, and 134 ± 59 cm/s, respectively. The mean PV-ratio at days 1, 30, and 90 were 9.3 ± 5.0, 3.5 ± 1.9, and 2.0 ± 1.3, respectively. Linear mixed-effects model revealed a significant main effect of timepoint on SCr, TRVS-PV, and PV-ratio (p < 0.01 for all), exhibiting a gradually declining trend. There was no significant main effect of timepoint on arterial parameters.
Conclusion: TRVS unrelated to thrombotic causes in the early post-operative period is a transient finding not correlating with short-term outcome.