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Infrainguinal revascularization after renal transplantation
Claudie S McArthur1, Malachi G Sheahan, Frank B Pomposelli
1Division of Vascular Surgery, Beth Israel Deaconess Medical Center, 110 Francis St, Ste 5B, Boston, MA 02215, USA.
Journal of Vascular Surgery
|May 24, 2003
Summary
Infrainguinal bypass surgery is safe for renal transplant recipients. A well-functioning kidney transplant significantly improves patient survival after lower extremity arterial revascularization.
Area of Science:
- Vascular Surgery
- Nephrology
- Transplantation Medicine
Background:
- End-stage renal disease (ESRD) correlates with poor outcomes in arterial revascularization.
- The impact of renal transplantation on these outcomes remains understudied.
Purpose of the Study:
- To analyze the outcomes of infrainguinal bypass procedures in patients with functioning renal allografts.
- To compare outcomes with historical data for patients with ESRD.
Main Methods:
- Review of a prospectively maintained vascular registry from 1990-2002.
- Identification of 60 patients with functioning renal allografts undergoing infrainguinal bypass.
- Kaplan-Meier analysis for limb salvage, patency, and patient survival.
Main Results:
- 60 patients underwent 76 bypass procedures; 98.3% had diabetes.
- 5-year survival was 66.6%; limb salvage was 78%; primary patency was 44%.
- Preoperative serum creatinine ≤2.0 mg/dL correlated with improved 5-year patient survival (73.4% vs. 37.5%, P=.01).
Conclusions:
- Infrainguinal bypass is safe and effective in renal transplant recipients.
- A well-functioning renal allograft is crucial for enhancing patient survival post-revascularization.