[Surgical management of abdominal aortic aneurysms in kidney transplanted patients]

From April 1995 to April 2006, four patients, three male and one female, age range 56 to 68 years (average 62), with a renal transplant, underwent the surgical management of an abdominal aortic aneurysm. As a consequence of the high vulnerability of the transplanted kidney to the ischemia and the occurrence of frequent calcifications of the arterial wall in these patients, the aortic clamping time required for the aneurysm repair is sometimes unpredictable and prolonged ischemia may have deleterious effects on the renal function. To avoid this potential and ominous complication, the authors employed a method for renal protection, consisting in the temporary implantation of an extracorporeal axillary-femoral bypass, removed at the end of the operation. Average aortic clamping time was 36,5 minutes, all patients passed urine during that period of time and no significant alterations were noticed in the daily serum creatinine levels, following the procedure. There was no mortality nor significant morbidity and the implantation and removal of the shunt were uneventfull. The extracorporeal transient axillo-femoral bypass seems to be, according to our experience, an easy and valuable method for protection of the kidney transplant in patients requiring abdominal aortic aneurysm repair.