腎移植後早期の移植腎動脈解離に対しPTAが奏効した1例

抄録

Renal artery dissection is one of the most serious complications following renal transplantation, which can lead to perfusion failure and result in graft dysfunction and loss. We present a case of renal artery intimal dissection which occurred during the early post-renal transplantation period. A-45-year-old female on hemodialysis underwent livingrelated renal transplantation. The serum creatinine levels gradually decreased to 2.0 mg/dL until 8days after the surgery, then turned to increase at day 9. At that point, a perfusion failure was considered due to a renal artery stenosis. However, an intimal flap was clearly detected in the graft artery lumen by use of an intravascular ultrasound (IVUS)，and the renal artery dissection was diagnosed. A percutaneous transluminal angioplasty (PTA) was successfully performed to the artery dissection at day 13. The patient's serum creatinine levels immediately started to decrease and it reached around 1.1 mg/dL within 2 months, then stable to the present. The IVUS is useful to detect intimal flaps and the PTA can help achieve recovery of graft renal function due to artery intimal dissection following renal transplantation.