Pediatric transplantation · 2026
Silent but Severe: Transplant Renal Artery Stenosis Causing Acute Graft Dysfunction in a Child With Cystinosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Becerir Tülay, Altıntaş Ümmühan Seda, Girişgen İlknur, Kabukcuoğlu Miraç Burak, Kılıç Pınar, Arslan Muhammet
Аннотация
BACKGROUND: Transplant renal artery stenosis (TRAS) is a potentially reversible vascular complication after kidney transplantation and an important cause of graft dysfunction in children. It usually presents with hypertension and/or impaired graft function but may occasionally remain clinically silent.
CASE PRESENTATION: We report an 11-year-old girl with cystinosis who underwent living-donor kidney transplantation outside our national, regulated transplant program and was referred to our center for follow-up. Early post-transplant Doppler ultrasonography was normal. At 10 weeks post-transplant, she developed an asymptomatic but severe rise in serum creatinine without hypertension. Imaging revealed a short, focal stenosis at the arterial anastomosis. Percutaneous transluminal angioplasty was successfully performed, followed by short-term anticoagulation and antiplatelet therapy, with rapid and sustained recovery of graft function.
CONCLUSION: This case highlights that TRAS may present without hypertension and underscores the importance of careful surveillance, particularly in children transplanted outside regulated transplant programs.
CASE PRESENTATION: We report an 11-year-old girl with cystinosis who underwent living-donor kidney transplantation outside our national, regulated transplant program and was referred to our center for follow-up. Early post-transplant Doppler ultrasonography was normal. At 10 weeks post-transplant, she developed an asymptomatic but severe rise in serum creatinine without hypertension. Imaging revealed a short, focal stenosis at the arterial anastomosis. Percutaneous transluminal angioplasty was successfully performed, followed by short-term anticoagulation and antiplatelet therapy, with rapid and sustained recovery of graft function.
CONCLUSION: This case highlights that TRAS may present without hypertension and underscores the importance of careful surveillance, particularly in children transplanted outside regulated transplant programs.