The significance of ipsilateral leg ischaemia after renal transplantation.

We present three renal transplant patients who have been investigated for leg ischaemia on the side of the transplant. All were men aged between 50 and 57 years. Two had an iliac stenosis proximal to the transplant kidney and were treated successfully by percutaneous transluminal angioplasty. The other, with an internal iliac anastomosis, had occlusion of the external iliac artery and underwent femoro-femoral bypass grafting. Eight years later, almost 17 years after transplantation, this hyperlipidaemic patient was found to have an internal iliac origin stenosis proximal to the transplant kidney and also underwent successful angioplasty. In patients with functioning renal transplants, symptoms of arterial insufficiency in the ipsilateral leg should be investigated urgently because a proximal iliac stenosis potentially threatens graft survival.