Regional extra-corporeal circulation to protect transplanted kidney and pancreas from ischemia during vascular reconstruction.
The development of severe aorto-ilio-femoral atherosclerotic disease in a patient with a previous double transplantation, kidney and pancreas, is a major surgical challenge. The transplanted organs have to be protected from extensive ischemia during the vascular reconstructive procedure and achieve optimal revascularization. The surgical management of a complex case where regional extra-corporeal circulation was used to protect transplanted pancreas and kidney during aorto-bifemoral vascular grafting in a 39 yr old diabetic patient is described. Regional femoro-femoral extra-corporeal circulation with an oxygenator is a safe technique that allows time for the proximal revascularization, minimizes the warm organ ischemia time and results in preservation of organ function.
Faidutti
Bernard
B
Clinic of Cardiovascular and Thoracic Surgery, University Hospital, CH-1211 14, Geneva, Switzerland.
Bednarkiewicz
Marek
M
Morel
Philippe
P
Kalangos
Afksendyios
A
Christenson
Jan T
JT
D000328:Adult; D001011:Aorta / Q000503:physiopathology / Q000601:surgery; D001162:Arteriosclerosis Obliterans / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000503:physiopathology / Q000601:surgery; D007511:Ischemia / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D016030:Kidney Transplantation; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D016035:Pancreas Transplantation; D012086:Reoperation; D013997:Time Factors