title: Revascularization and rescue of a failed kidney transplant in a case of autosomal dominant polycystic kidney disease.
abstract: Autosomal dominant polycystic kidney disease is a cause of end-stage renal disease associated with abdominal aortic aneurysms. We report a patient with autosomal dominant polycystic kidney disease who received an allograft kidney and subsequently underwent treatment of an abdominal aortic aneurysm with aortic ligation and axillary-bifemoral bypass. After years of graft function, bypass thrombosis resulted in dialysis-dependent renal failure. Aortobifemoral bypass resulted in immediate restoration of allograft function despite 6 months of prior renal failure. Aortic reconstruction restored renal function to a hibernating allograft long after clinical graft failure from arterial ischemia, a phenomenon not previously reported in the literature.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Anupamaa
authors.initials: A
authors.lastname: Seshadri
authors.forename: Christopher
authors.initials: C
authors.lastname: Byrne
authors.forename: Andrew
authors.initials: A
authors.lastname: Kramer
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Bartlett
authors.forename: Rajabrata
authors.initials: R
authors.lastname: Sarkar
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003097:Collateral Circulation; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications / Q000601:surgery*; D012079:Renal Circulation; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D016879:Salvage Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure