BACKGROUND: We would like to present an unusual case of simultaneous stenosis of renal graft artery and vein diagnosed four months after transplantation. both treated by stent placement. Our aim is to point at the fact that renal graft venous stenosis is very rarely reported in the literature and - as it is not easy to diagnose by routine US - it could be overlooked. If early detected it can be treated by stent placement. CASE PRESENTATION: We present a case of 36-old-male with renal failure who received a kidney graft from deceased donor. The patient experienced delayed graft function. No rejection was found in the biopsy. Four months after transplantation the kidney function deteriorated to sCr 280 µmol/l. Graft artery stenosis together with graft vein stenosis was revealed. Both lesions were dilated with stent placement, the graft function returned to 230 µmol/l and became stable for 10 years. Ten years after stent placement graft function deteriorated to 300 µmol/l. An in stent restenosis of arterial stent was detected. It was successfully dilated by the balloon, the graft function returned to 230 µmol/l and stays stable for another 5 years. CONCLUSIONS: An unusual simultaneous transplanted kidney artery and vein stenosis treated by stent placement is presented. The patient had stable graft function for 15 years after the procedure with one re-intervention on arterial stent.

Dept Nephrology Transplant Center Institute for Clinical and Experimental Medicine Prague Czech Republic

Dept of Diagnostic and Interventional Radiology Institute for Clinical and Experimental Medicine Prague Czech Republic

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Aktas S, Boyvat F, Sevmis S, Moray G, Karakayali H, Haberal M. Analysis of vascular complications after renal transplantation. Transpl Proc. 2011;43(2):557–61. PubMed

Patel NH, Jindal RM, Wilkin T, Rose S, Johnson MS, Shah H, Namyslowski J, Moresco KP, Trerotola SO. Renal arterial stenosis in renal allografts: retrospective study of predisposing factors and outcome after percutaneous transluminal angioplasty. Radiology. 2001;219(3):663–7. PubMed

Pini A, Faggioli G, Pini R, Mauro R, Gallitto E, Mascoli C, Grandinetti V, Donati G, Odaldi F, Ravaioli M, La Manna G, Gargiulo M. Assessment and Management of Transplant Renal artery stenosis. A literature review. Ann Vasc Surg. 2022;82:13–29. PubMed

Dimitroulis D, Bokos J, Zavos G, Nikiteas N, Karidis NP, Katsaronis P, Kostakis A. Vascular complications in renal transplantation: a single-center experience in 1367 renal transplantations and review of the literature. Transplant Proc. 2009;41(5):1609-14. PubMed

Obed A, Zorger DC, Scherer NFS, Krüger MN, Banas B, Krämer B. Severe renal vein stenosis of a kidney transplant with beneficial clinical course after successful percutaneous stenting. Am J Transpl. 2008;8(10):2173–6. PubMed

Mei Q, He X, Lu W, Li Y. Renal vein stenosis after renal transplantation: treatment with stent placement. J Vasc Interv Radiol. 2010;21(5):756–8. PubMed

Cercueil JP, Chevet D, Mousson C, Tatou E, Krause D, Rifle G. Acquired vein stenosis of renal allograft–percutaneous treatment with self-expanding metallic stent. Nephrol Dial Transpl. 1997;12(4):825–6. PubMed

Jones G, Tibballs J, Al-Akraa M, Sweny P. Iliac vein stenosis as a reversible cause of renal transplant dysfunction. Nephrol Dial Transpl. 2004;19(9):2415–6. PubMed

Fava M, Loyola S, Flores P, Del Campo F. External iliac vein thrombosis after renal transplantation: treatment by thrombolysis and stent placement: a case report. Transplantation. 1997;64(6):928–30. PubMed