Vascular complications in the adult kidney transplant recipient.

Vascular complications of renal transplantation occurred in 15% of the cases. They are thrombotic infarct, arterial stenosis, arterio-venous fistula, and chronic arterial diseases. From 900 renal transplantations performed, only 120 (made since 1989) were studied with color flow Doppler (CFD). Lack of arterial signal is indicative of main arterial thrombosis (or of renal infarct if thrombosis is limited). At the site of arterial stenosis, high velocity and turbulence are found. If the stenosis is more than 70%, the rising systolic time is longer than 0.07 sec in the post-stenotic artery. Arterio-venous fistulas are frequent after renal biopsy. They provoke vibrations transmitted to peri-vascular tissues and seen with CFD as a large area of turbulence. In the feeding artery, Fast Fourier Transformation (FFT) showed a high velocity with a low resistive index and pulsed flow in the outgoing vein. Chronic arterial diseases include cyclosporine A intoxication and chronic rejection. These two diseases cannot be diagnosed by CFD alone.