Graft Kidney Artery Stenosis in a Deceased Donor Kidney Transplant Recipient with Autosomal Dominant Polycystic Kidney Disease: A Case Report

Introduction: This paper presents a case study of a rare instance of transplant renal artery stenosis caused by mechanical compression from the native polycystic kidney in a recipient with ADPKD who received a kidney from a deceased donor. Case Description: A 53-year-old man received a kidney transplant from a deceased donor. On the fourth day post-surgery, underwent color Doppler ultrasound (Fig 1-A) and CT angiography (Fig 1-B) to assess vascular issues, revealing renal artery stenosis in the transplanted kidney. The patient underwent reoperation to correct TRAS, we confirmed that the right native polycystic kidney compressed the transplanted kidney, causing it to rotate medially, resulting in the stenosis of the renal artery. (Fig 2-A) Right nephrectomy of the native polycystic kidney, and straightening of the renal artery of the transplanted kidney to relieve compression. (Fig 2-B) After the surgical resection, renal function and urine output were well-maintained, and the blood pressure remained stable. Discussion: Our focus on TRAS is due to its classification as one of the reversible complications linked to hypertension, as well as its association with the dysfunction of transplanted kidneys. This perspective underscores the importance of early detection and management of TRAS to ensure successful outcomes for the transplant recipients. We hope that by introducing this case, we can gain some insights for dealing with similar patients who develop renal artery stenosis.Figure 1. A: US color Doppler kidney. Peak velocity in the anastomotic site of renal artery is increased, more than 250 cm/s., B: CT angiography. Revealing renal artery stenosis in the transplanted kidney. (arrow)Figure 2. A: The transplant renal artery stenosis was confirmed through surgical intervention., B: Surgical resection of the right native polycystic kidney.