Transplant renal artery stenosis

Case contributed by Dr Mohammad Eisa


A known kidney transplant patient (3 years ago ), presented with hypertension and recently elevated kidney functions.

Patient Data

Age: 60 years
Gender: Male

The kidney graft shows average size with normal echogenicity and good cortico-medullary differentiation. No stones or back pressure changes. It shows homogeneous internal vascularity on power Doppler. Increased renal arterial resistive index, varying between 0.76 and 0.93. The intra-renal arcuate arteries show damped monophasic Doppler waveform.

The renal transplant artery anastomosis shows aliasing on color Doppler. Spectral Doppler shows increased PSV about 4 m/s. The adjacent right external iliac artery shows maximum velocity of 170 cm/s. There’s therefore a 2.3 : 1 ratio between the transplant artery and external iliac

The renal vein is patent with proper respiratory variability.

Case Discussion

The findings are highly suggestive of transplant renal artery stenosis (TRAS).

PlayAdd to Share

Case information

rID: 68667
Published: 11th Jun 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Al azhar university

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.