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Aortic reconstruction in patients with functioning renal allografts
Christopher L Skelly1, Amy J Farmer, Michael A Curi
1Section of Vascular Surgery MC 5028, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637, USA.
Annals of Vascular Surgery
|October 31, 2002
Summary
Vascular surgeons can successfully reconstruct aortas in patients with transplanted kidneys using standard open surgery. Minimizing warm renal ischemia time is key to preserving kidney function during these complex aortic procedures.
Area of Science:
- Vascular Surgery
- Transplant Surgery
- Nephrology
Background:
- Aortic reconstruction in patients with functioning renal allografts presents significant surgical challenges.
- Established methods for renal allograft preservation include hypothermia, shunts, perfusion, bypass, and endovascular techniques.
Observation:
- Two cases are presented involving patients with renal allografts originating from the external iliac artery requiring aortic reconstruction.
- Case 1: A 55-year-old with aortic and iliac aneurysms underwent aorto-femoral/iliac bypass, limiting warm renal ischemia to 34 minutes.
- Case 2: A 44-year-old with aortoiliac occlusive disease and hypertension underwent aorto-femoral bypass with crossover, limiting warm renal ischemia to 20 minutes.
Findings:
- Both patients underwent successful aortic reconstruction using standard open surgical techniques.
- Both patients recovered without any decline in renal function and remain well on follow-up.
- Minimizing warm renal ischemia time was crucial for successful outcomes.
Implications:
- Standard open surgery is a viable option for aortic reconstruction in renal allograft recipients.
- Careful surgical planning to minimize warm renal ischemia is essential for preserving allograft function.
- These findings support the use of conventional surgical approaches when warm ischemia can be effectively managed.