[Renal transplant in a patient with aortobifemoral bypass]

Over the last few years we see an increase in the number of patients with vascular disease who need a renal transplant. We discuss their management and different therapeutic options available.

We report the case of a female patient with history of systemic vascular disease having undergone multiple surgical procedures for it, including aortobifemoral bypass, presenting with end stage renal disease. A kidney transplant into the right iliac fossa was carried out with end to side vascular anastomosis to the iliac vein and arterial vascular prosthesis, respectively. The main difficulty came from the existence of an important fibrosis around the prosthesis, which forced a much more careful dissection of the iliac vein. Immediate postoperative course was uneventful, and the graft shows a normal function two years after surgery.

The coexistence of vascular and renal disease is not a contraindication for kidney transplantation. Larger experience is required, but published data to date do not show significant differences on graft or patient survival.