Transplant renal artery stenosis
A known kidney transplant patient (3 years ago ), presented with hypertension and recently elevated kidney functions.
Loading Stack -
0 images remaining
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.
The findings are highly suggestive of transplant renal artery stenosis (TRAS).