Abdominal Aortic Aneurysm Repair in Patient with a Renal Allograft: A Case Report

Renal transplant recipients requiring aortic reconstruction due to abdominal aortic aneurysm (AAA) pose a unique clinical problem. The concern during surgery is causing ischemic injury to the renal allograft. A variety of strategies for protection of the renal allograft during AAA intervention have been described including a temporary shunt, cold renal perfusion, extracorporeal bypass, general hypothermia, and endovascular stent-grafting. In addition, some investigators have reported no remarkable complications of the renal allograft without any specific measures. We treated a case of AAA in a patient with a renal allograft using a temporary aortofemoral shunt with good result. Since this technique is safe and effective, it should be considered in similar patients with AAA and previously placed renal allografts.

[1]  I. Moon,et al.  Abdominal aortic aneurysm repair in kidney transplant recipients. , 2006, Transplantation proceedings.

[2]  M. Castagneto,et al.  Abdominal aortic aneurysm in renal transplant recipients. , 2005, Transplantation proceedings.

[3]  M. Englesbe,et al.  The prevalence and natural history of aortic aneurysms in heart and abdominal organ transplant patients. , 2003, Journal of vascular surgery.

[4]  R. Stoney,et al.  Aortic clamping during elective operations for infrarenal disease: The influence of clamping time on renal function. , 2002, Journal of vascular surgery.

[5]  N. Senninger,et al.  Stent graft of abdominal aortic aneurysm after renal transplantation , 2002, Annals of vascular surgery.

[6]  K. Harris,et al.  Endovascular Repair of Abdominal Aortic Aneurysm with Coexisting Renal Allograft: Case Report and Literature Review , 2001, Annals of vascular surgery.

[7]  V. Kashyap,et al.  Abdominal Aortic Aneurysm Repair in Patients with Renal Allografts , 1999, Annals of vascular surgery.

[8]  R. Korula,et al.  Transplant kidney protection during aortic aneurysm surgery. , 1999, The Journal of urology.

[9]  W. Greenlee,et al.  Renal protection by a dual ETA/ETB endothelin antagonist, L-754,142, after aortic cross-clamping in the dog. , 1997, Journal of the American Society of Nephrology : JASN.

[10]  P. Pairolero,et al.  Aortic reconstruction in kidney transplant recipients , 1996, Annals of vascular surgery.

[11]  T. O'donnell,et al.  The effect of suprarenal cross-clamping on abdominal aortic aneurysm repair. , 1992, Archives of surgery.

[12]  P. Kalmar,et al.  Abdominal aortic aneurysm repair after renal transplantation with extracorporeal bypass. , 1991, The Thoracic and cardiovascular surgeon.

[13]  M. Lacombe.  Aortoiliac surgery in renal transplant patients. , 1991, Journal of vascular surgery.

[14]  E. Leen,et al.  Histologic characteristics of carotid artery plaque. , 1991, Journal of vascular surgery.

[15]  A. Ward,et al.  Supraceliac clamping: An underused alternative in aortic surgery , 1990, Annals of vascular surgery.

[16]  J. Najarian,et al.  Definition of normothermic ischemia limits for kidney and pancreas grafts. , 1986, The Journal of surgical research.

[17]  J. S. Yao,et al.  Use of a temporary shunt for renal transplant protection during aortic aneurysm repair. , 1983, Surgery.

[18]  Nghiem Dd,et al.  In situ hypothermic preservation of a renal allograft during resection of abdominal aortic aneurysm. , 1982 .

[19]  D. Nghiem,et al.  In situ hypothermic preservation of a renal allograft during resection of abdominal aortic aneurysm. , 1982, The American surgeon.