title: Impact of Endovascular Aortic Aneurysm Repair in a Renal Transplantation Program.
abstract: BACKGROUND
  An increasing number of abdominal aortic aneurysms (AAAs) may occur in renal failure patients waiting for kidney transplantation because of sharing atherosclerotic risk factors. There is increasing possibility to diagnose an AAA in this group, where treatment has some particularities. After aneurysm treatment these patients remain candidates to kidney transplantation. Similarly, there is an increasing possibility to diagnose AAA in kidney transplantation recipients. Our aim is to present our experience and review the published literature.
  
  
  METHODS
  We studied the patients who underwent endovascular aneurysm repair (EVAR) and were later submitted to kidney transplantation, and the patients who underwent kidney transplantation and were later diagnosed with AAA and treated by EVAR.
  
  
  RESULTS
  Our experience with renal transplantation began in 1987 and with EVAR in 2001. We performed EVAR in 3 kidney transplantation recipients, without complications as endoleaks or loss of the transplanted kidney. We performed kidney transplantation in 2 patients who underwent EVAR.
  
  
  CONCLUSIONS
  As patients waiting for kidney transplantation wait for several months to years, necessity to treat the aortic aneurysm is sometimes imperative. EVAR is the preferred method in this high-risk group with the particularity of necessity to preserve the internal/external iliac arteries to allow anastomosis between renal artery of the transplanted kidney and recipient's iliac artery. Ensuring this, kidney transplantation remains possible and we did not detect differences in comparison with a regular procedure. Kidney transplantation recipients have some particularities as immunosuppressive therapy; in this group, EVAR was recognized as less aggressive and with less impact in renal function.
authors.affiliation: Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Machado
authors.affiliation: Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar do Porto, Porto, Portugal. Electronic address: ines_edd@hotmail.com.
authors.forename: Inês
authors.initials: I
authors.lastname: Antunes
authors.affiliation: Departamento de Estudo de Populações, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Oliveira
authors.affiliation: Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Loureiro
authors.affiliation: Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Almeida
authors.affiliation: Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Pereira
authors.affiliation: Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: de Almeida
mesh_terms: D000328:Adult; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014850:Waiting Lists