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Aortic reconstruction in kidney transplant recipients
J M Panneton1, P Gloviczki, L G Canton
1Division of Vascular Surgery, Mayo Clinic, Rochester, Minn 55905, USA.
Annals of Vascular Surgery
|March 1, 1996
Summary
Aortic reconstruction is safe for kidney transplant recipients. Specialized protection methods like shunts or cold perfusion minimize ischemic injury, preserving transplanted kidney function and preventing loss.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Transplantation Medicine
Background:
- Renal transplantation improves longevity in uremic patients.
- Aortic reconstruction in these patients poses a risk of ischemic injury to the transplanted kidney.
- Evaluating renal outcomes and protection strategies is crucial.
Purpose of the Study:
- To assess the safety and outcomes of aortic reconstruction in kidney transplant recipients.
- To identify effective renal protection methods during aortic repair.
- To determine the risk of renal failure and transplant loss.
Main Methods:
- Retrospective review of 10 kidney transplant recipients undergoing aortic reconstruction (1977-1994).
- Analysis of patient demographics, reasons for aortic repair, and surgical techniques.
- Evaluation of renal protection strategies including shunts, cold perfusion, and topical cooling.
Main Results:
- Eight of nine survivors maintained native renal function; none lost the transplanted kidney.
- One patient experienced a transient increase in serum creatinine.
- One patient died from respiratory failure unrelated to renal function.
Conclusions:
- Aortic reconstruction can be performed safely in kidney transplant recipients.
- Thoracic/thoracoabdominal repairs utilized bypass/shunts for protection.
- Abdominal repairs benefited from cold renal perfusion, with or without topical cooling.