Post-transplant Vascular Complications In Kidney Transplant Recipients
Vascular
complications after kidney transplantation are relatively uncommon but may have
a major impact on graft survival and patient morbidity. These complications
involve the graft arterial inflow, graft venous outflow, or recipient iliac
vessels, and may present in the early or late post-transplant period. Their
mechanisms are multifactorial and commonly reflect varying contributions of
vessel wall injury, disturbed flow, and thrombotic predisposition. Among them,
transplant renal artery stenosis is the most frequent vascular complication and
is often amenable to endovascular or surgical treatment, whereas arterial and
venous thrombosis remain major causes of early graft loss. Biopsy-related
arteriovenous fistulae and intrarenal pseudoaneurysms are usually benign but
may require intervention in selected patients. Mechanical lesions such as
arterial kinking, venous compression, and iliac vessel pathology should also be
recognized, as delayed diagnosis may result in irreversible graft injury. This
chapter reviews the classification, mechanisms, risk determinants, clinical
presentation, imaging findings, and treatment principles of the major vascular
complications after kidney transplantation, with emphasis on practical
diagnostic reasoning and timely management.
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