title: [Arterial anastomotic aneurysms after kidney and pancreas transplantation: diagnosis and management].
abstract: OBJECTIVE
  The objective of our study was to assess the frequency, circumstances of diagnosis and treatment of anastomotic arterial aneurysms and compare them to the literature.
  
  
  METHODS
  A single-center series of 3000 kidney transplants and 126 pancreas transplants between 1974 and 2010 was studied retrospectively. Ten patients had anastomotic arterial aneurysms: eight after kidney transplantation and two after pancreas-kidney transplantation. Diagnosis was based on the association Doppler ultrasonography-angioscanner.
  
  
  RESULTS
  Ten arterial anastomotic aneurysms were identified. The circumstances of discovery were clinical in eight cases, half of them by hemodynamic collapsus. A majority of our patients (60%) were diagnosed in the year following the transplantation and two cases were discovered after transplantectomy. Pancreas-kidney transplantation had a high risk for arterial anastomotic aneurysm. Candida albicans was isolated in preoperative samples in four cases. The management consisted to transplantectomy in seven patients, revascularization of the lower limb in six patients and one renal transplant preservation. We found two lower limb ischemia and two deaths by a fatal intraoperative haemorrhage and vascular cerebral haemorrhage. No recurrence was identified after in the follow-up ranged from 20 months to 12 years.
  
  
  CONCLUSIONS
  Arterial anastomotic aneurysm was in our study a serious complication that requires emergency surgery. The transplantectomy followed by revascularization of the limb is the treatment of choice associated to an appropriate antifungal or antibiotic treatment.
authors.affiliation: Service d'urologie, groupe hospitalier Paris Sud, AP-HP, 63, avenue G.-Peri, 94275 Le Kremlin-Bicêtre, France. lahbib006@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Aoubid Iaaza
authors.forename: T
authors.initials: T
authors.lastname: Bessede
authors.forename: P
authors.initials: P
authors.lastname: Eschwege
authors.forename: Y
authors.initials: Y
authors.lastname: Hammoudi
authors.forename: A
authors.initials: A
authors.lastname: Durrbach
authors.forename: G
authors.initials: G
authors.lastname: Benoît
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D000783:Aneurysm / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D001158:Arteries / Q000601:surgery; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D055815:Young Adult