Hypertension following renal transplantation may be caused by narrowing of either native or donor arteries or their anastomosis. A case is presented of attempted percutaneous angioplasty of a severely stenotic donor renal artery which resulted in total occlusion necessitating emergency reparative surgery. While short segments of narrowing of the native artery or anastomosis are lesions manageable by percutaneous transluminal angioplasty, lesions involv ing a donor artery should be approached with care, particularly if the segment of narrowing is longer, resembling the lesions of fibromuscular dysplasia.
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