title: Successful repair of post-transplant mycotic aneurysm of iliac artery with renal graft preservation: a case report.
abstract: OBJECTIVE
  To describe the successful repair of a post-transplant iliac artery aneurysm with renal graft preservation.
  
  
  METHODS
  An aneurysm was detected in an asymptomatic 47-year-old male recipient on routine Doppler ultrasonography that involved the right external iliac artery and the distal portion of the renal artery. Aneurysm resection was performed immediately after diagnosis 3 months after transplantation. A polytetrafluorethylene tube graft was used for reconstruction of the right external iliac artery. Reconstruction of the renal artery required interposition of a vena saphena graft between the proximal portion of the renal artery and the polytetrafluorethylene tube.
  
  
  RESULTS
  The total warm ischemia time used for aneurysm repair and renal transplant revascularization was 90 minutes. The postoperative Doppler ultrasound scan showed homogeneous graft perfusion. Pathologic and microbiologic examination of the resected aneurysm revealed Candida albicans arteritis. The center in which the contralateral donor kidney was transplanted had previously reported Candida albicans contamination of the preservation solution. The recipient of the contralateral kidney lost his graft owing to bleeding complications. Information on this incident was acquired by our center only after aneurysm repair. Postoperatively, our recipient was given systemic antifungal therapy. At 6 months, the serum creatinine level was 1.7 mg/dL.
  
  
  CONCLUSIONS
  Although a high-risk procedure, repair of a mycotic aneurysm with renal graft preservation is feasible. Routine microbiologic screening of the preservation solution might help to detect and treat donor-transmitted infections in renal transplant recipients.
authors.affiliation: Department of Urology, Charité - University Medicine Berlin, Berlin, Germany. christina.kountidou@charite.de
authors.forename: Christina S
authors.initials: CS
authors.lastname: Kountidou
authors.forename: Katja
authors.initials: K
authors.lastname: Stier
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Niehues
authors.forename: Anja
authors.initials: A
authors.lastname: Lingnau
authors.forename: Martin
authors.initials: M
authors.lastname: Schostak
authors.forename: T Florian
authors.initials: TF
authors.lastname: Fuller
authors.forename: Ronald
authors.initials: R
authors.lastname: Lützenberg
mesh_terms: D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002177:Candidiasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D018608:Ultrasonography, Doppler; D014656:Vascular Surgical Procedures / Q000379:methods*