Vascular in renal transplant recipients, although uncommon, may pose risks to graft function and patient outcomes. This study investigated the prevalence and characteristics of saphenofemoral junction (SFJ) reflux and lower-limb venous parameters in kidney transplant recipients.

In this cross-sectional study, patients with a history of kidney transplantation referred to Sina Hospital in Tehran, Iran, from January 2022 to 2024 were included. Duplex ultrasound was used to assess the presence of SFJ reflux, SFJ reflux time, and the diameters of the great saphenous vein (GSV), common iliac vein, external iliac vein, and common femoral vein.

A total of 280 patients were evaluated, with a mean age of 39.52 ± 10.18 years; 227 patients were male (81.1%). The transplanted kidney was located on the right side in 192 patients (68.6%). SFJ reflux was identified in 30 patients (10.7%), of whom 56.7% had bilateral reflux. There was no significant relationship between SFJ reflux and the side of the transplanted kidney (p = 0.273). The GSV diameter was increased in 29.3% of patients on the transplant side and in 24.6% on the contralateral side. The diameters of the common iliac veins were normal in all patients. External iliac vein diameter was increased in 14.3% of patients on the transplant side and in 16.8% on the contralateral side.

SFJ reflux was observed in 10.7% of kidney transplant recipients. No significant association was found between SFJ reflux and the side of the transplanted kidney. Lower-limb venous diameter parameters did not differ significantly between the transplant side and the contralateral side.