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Updated: Feb 15, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Aortic bypass surgery for asymptomatic patients awaiting a kidney transplant: A word of caution
Quentin Franquet1, Nicolas Terrier1, Augustin Pirvu2
1Department of Urology and Kidney Transplantation, Grenoble University Hospital, Grenoble, France.
Insights
Aortic bypass surgery before kidney transplantation in asymptomatic patients carries significant risks. While outcomes are good if transplantation is successful, careful patient selection is crucial.
Area of Science:
- Vascular Surgery
- Nephrology
- Transplantation Medicine
Background:
- Severe aorto-iliac calcification may necessitate aortic bypass surgery for kidney transplantation.
- This strategy is typically reserved for patients with vascular-related symptoms.
Purpose of the Study:
- To evaluate the safety and outcomes of aortic bypass surgery prior to kidney transplantation in asymptomatic patients.
- To assess the feasibility and success rates of this approach in a specific patient cohort.
Main Methods:
- Retrospective review of patients undergoing vascular bypass surgery before kidney transplantation (November 2004 - March 2016).
- Inclusion criteria: asymptomatic patients undergoing aortic bypass surgery prior to kidney transplantation.
Main Results:
- Twenty-one asymptomatic patients were included; 48% did not receive a transplant.
- Mortality rate was 9.5% (2 deaths related to bypass surgery).
- Transplanted patients (52%) were younger and less likely to have coronary heart disease.
Conclusions:
- Aortic bypass surgery before kidney transplantation in asymptomatic individuals has notable mortality and morbidity.
- Successful transplantation yields satisfying results, but careful selection criteria (age, coronary heart disease) are needed.
- Further research is required to refine patient selection for this procedure.
Introduction:
In the presence of severe aorto-iliac calcification, aortic bypass surgery can be mandatory to allow kidney transplantation. The aim of our study was to evaluate the safety and outcomes of this strategy among asymptomatic patients.
Materials And Methods:
We retrospectively reviewed the files of all patients that had undergone vascular bypass surgery prior to kidney transplantation between November 2004 and March 2016. All patients undergoing aortic bypass surgery prior to kidney transplantation without any vascular-related symptoms were included.
Results:
Twenty-one asymptomatic patients were included. Ten patients (48%) have not received a kidney transplant. Four patients died before kidney transplantation, including 2 deaths related to the bypass surgery (9.5%). Early post-operative morbidity involved 11 cases. Eleven patients (52%) were transplanted. Transplanted patients were significantly younger (median age 60 [56-61] vs 67 [60-72] years, P = .04) at the time of bypass and were less frequently treated for coronary heart disease (9% vs 50%, P = .06).
Conclusion:
Aortic bypass surgery performed prior to kidney transplantation among asymptomatic patients has significant mortality and morbidity rates. When transplantation is possible, the results are satisfying. Larger studies are required to define the selection criteria, such as age and coronary heart disease.
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