To compare the value of different diagnostic methods on transplant renal artery stenosis (TRAS) and summarize the treatment experience of interventional therapy on TRAS.

The clinical data of 25 recipients who suffered TRAS after renal transpantation in Renmin Hospital of Wuhan University from January 2010 to June 2017 were analysed. All recipients accepted color doppler flowing image (CDFI), magnetic resonance angiography (MRA) and digital subtraction angiography (DSA). Recipients received interventional therapy immediately after they were diagnosed with TRAS by DSA, mild stenosis recipients were treated with balloon dilatation, moderate stenosis and severe stenosis recipients were treated with balloon dilatation and artery stent. TRAS recipients were divided into fast blood flow group and slow blood flow group, the media peak systolic velocity (PSV) of transplant artery and resistance index between the 2 groups were compared. Diagnosis rate of CDFI and MRA on TRAS were compared with Fisher′s exact test. The indexes like 24 hour urine volume, mean arterial pressure, serum creatinine and glomerular filtration rate (GFR) before and after operation were compared with paired t test; the media PSV and resistance index of fast blood flow group and slow blood flow group were also compared with paired t test. P<0.05 was considered statitically significant.

Diagnosis rate of CDFI and MRA on TRAS were 68% (17/25) and 84.0% (21/25), which had no statitical significance (P=0.57). The test results of DSA showed that there were 7 cases of mild stenosis recipients, 13 cases of moderate stenosis recipients and 5 cases of severe stenosis recipients. All the mild stenosis recipients received balloon dilatation, other recipients received balloon dilatation and artery stent. Twenty-four hour urine volume, mean arterial pressure, serum creatinine and GFR of fast blood flow group and slow blood flow group before and after operation were (1 956±615) and (2 752±729) mL, (117±13) and (96±8) mmHg, (190±50) and (109±22) μmol/L, (39±12) and (66±8) mL/min, all of them had statitical significance (t=4.17, 6.59, 7.35, 9.48, P all<0.05). Media PSV and resistance index of fast blood flow group (n=17) before and after operation were (151±27) and (87±28) cm/s, 0.77±0.05 and 0.56±0.06, all of them had statitical significance (t=6.35, 4.38, P all<0.05). Media PSV and resistance index of slow blood flow group (n=8) before and after operation were (39±9) and (80±16) cm/s, (0.56±0.06) and (0.66±0.04), all of them had statitical significance (t=6.33, 3.92, P all<0.05). Postoperative follow-up time of 25 TRAS recipients was 4-36 months up to October 2017, complications like artery thrombosis and restenosis were not observed; gastrointestinal bleeding (n=1) and vena iliaca externa thrombosis (n=1) were observed after interventional therapy; 1 case catched pulmonary infection on the third day after interventional therapy and died of respiratory failure 1 month later.

MRA and CDFI perform similar value in diagnosing TRAS. Interventional therapycould rectify the clinical symptoms and renal function by restoring transplant renal blood filtration.