title: Effects of simultaneous iliac artery angioplasty on graft and patient survival after living-donor kidney transplantation.
abstract: BACKGROUND
  Renal transplant candidates with extended indications, such as older age and advanced atherosclerosis, are currently accepted onto the waiting list.
  
  
  METHODS
  We retrospectively evaluated the clinical outcomes of simultaneous kidney transplantation and angioplasty compared with transplantation alone.
  
  
  RESULTS
  We included 748 patients who underwent living-donor kidney transplant because of end-stage renal disease during a 5-year period, consisting of 27 kidney transplants with simultaneous angioplasty and 721 without additional vascular procedures. As candidates for simultaneous angioplasty and transplant, we considered patients with TransAtlantic Inter-Society Consensus type A and B aorto-iliac disease. We compared transplant outcomes in patients who did or did not receive simultaneous angioplasty. Although simultaneous iliac artery angioplasty was significantly related to recipient age, diabetes mellitus, hypertension, and coronary artery disease, it was not associated with graft (uncensored, P=0.937; death censored, P=0.981) or patient (P=0.804) survival during the follow-up period. In addition, simultaneous angioplasty was not associated with a higher risk of delayed graft function (P=0.099) or a longer hospital stay (P=0.790). There was no significant difference in mortality due to a cardiovascular event between the two groups (P=0.199).
  
  
  CONCLUSIONS
  Simultaneous iliac artery angioplasty and kidney transplantation in carefully selected patients can be performed safely with equivalent graft and patient survival to transplantation alone.
authors.affiliation: 1 Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. 2 Department of Surgery, Pusan National University Hospital, Pusan, Korea. 3 Department of Surgery, Korea University Anam Hospital, Seoul, Korea. 4 Address correspondence to: Yong-Pil Cho, M.D., Ph.D., Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Korea.
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Chung
authors.forename: Youngjin
authors.initials: Y
authors.lastname: Han
authors.forename: Heungman
authors.initials: H
authors.lastname: Jun
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Kwon
authors.forename: Yong-Pil
authors.initials: YP
authors.lastname: Cho
mesh_terms: D000328:Adult; D017130:Angioplasty / Q000379:methods*; D050197:Atherosclerosis / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D051799:Delayed Graft Function / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000401:mortality / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007083:Iliac Artery / Q000473:pathology*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors