Surgery for aortoiliac aneurysms in kidney transplant recipients.
With the increase of long-term survivors following renal transplantation, aorto-iliac aneurysms requiring surgical management may be encountered more often. Our experience with temporary shunts for renal transplant protection during aorto-iliac aneurysm repair is presented along with a literature review of all cases on the subject. Three male patients with a median age of 56 (range 50-61) years were operated on for a dissecting aneurysm of the common iliac artery in one, respectively abdominal aortic aneurysm in the two remaining patients. All patients had impaired transplant function preoperatively with a median serum creatinine level of 167 (range 134-202) micromol/L and a median blood urea nitrogen concentration of 15 (range 9-23) pmol/L. The intra- and postoperative course was uneventful in all patients. Median postoperative serum creatinine level and blood urea nitrogen concentration were 135 (range 123-151) micromol/L and 10 (range 9-11) pmol/L, respectively. Aorto-iliac surgery in renal transplant recipients can be performed without transplant protection. However, in patients with a deteriorated transplant function or if a prolonged aortic cross-clamp time is anticipated, renal allograft protection measures may be beneficial to prevent possible ischemic damage.
Reber
P U
PU
Department of Vascular Surgery, Inselspital, University of Bern, Switzerland.
Vogt
B
B
Steinke
T M
TM
Patel
A G
AG
Kniemeyer
H W
HW
D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006085:Graft Survival; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016030:Kidney Transplantation; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011859:Radiography; D051437:Renal Insufficiency / Q000150:complications / Q000601:surgery*; D012307:Risk Factors