Aortoiliac aneurysm repair in kidney transplant recipients

Luis R. Leon, Evan S. Glazer, John D Hughes, Trung D. Bui, Shemuel B. Psalms, Kaoru R. Goshima

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

A potential problem during endovascular aortic aneurysm repair (EVAR) or open repair in renal allograft patients is ischemia of the transplanted kidney. In this study, kidney transplant patients who underwent aortic aneurysm repair in our institution were added to similar cases extracted from the literature to represent the basis of this work. Comparisons between patients treated with open surgery versus EVAR were performed in terms of renal function. In the EVAR group, most aneurysms were infrarenal, and 84% were treated with modular bifurcated devices. Protective kidney allograft perfusion measures were not used. The pre- and postoperative Cr was 1.69 and 1.73 mg/dL, respectively (P =.412). All EVAR patients had good outcomes. Complications included 8 endoleaks and 1 limb ischemia case. Three patients died from aortic repair-unrelated reasons. In the open group, the pre-and postoperative Cr was 1.45 and 1.37 mg/dL, respectively (P =.055). Most cases were infrarenal and mostly treated by aortobiiliac bypasses. In 16%, no adjuvant allograft perfusion was provided. In the rest, temporary axillofemoral bypasses were used most often. Most outcomes were favorable (57%). Reported procedural-related complications included arterial embolism, wound infection, and pneumonia. Deaths were reported in 5 occasions (none allograft failure dependent). No differences in Cr between EVAR and open techniques (P =.13) were seen. Aneurysm repair in kidney transplant recipients is associated with excellent renal preservation. Adverse outcomes were all allograft failure independent in both groups. EVAR without special allograft protection measures seems to be equally effective as open surgery with or without adjuvant kidney transplant perfusion.

Original languageEnglish (US)
Pages (from-to)30-45
Number of pages16
JournalVascular and Endovascular Surgery
Volume43
Issue number1
DOIs
StatePublished - Feb 2009

Fingerprint

Aortic Aneurysm
Aneurysm
Allografts
Kidney
Perfusion
Ischemia
Transplants
Endoleak
Transplant Recipients
Wound Infection
Embolism
Pneumonia
Extremities
Equipment and Supplies

Keywords

  • Abdominal aortic aneurysm
  • EVAR
  • Kidney transplant

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Leon, L. R., Glazer, E. S., Hughes, J. D., Bui, T. D., Psalms, S. B., & Goshima, K. R. (2009). Aortoiliac aneurysm repair in kidney transplant recipients. Vascular and Endovascular Surgery, 43(1), 30-45. https://doi.org/10.1177/1538574408322654

Aortoiliac aneurysm repair in kidney transplant recipients. / Leon, Luis R.; Glazer, Evan S.; Hughes, John D; Bui, Trung D.; Psalms, Shemuel B.; Goshima, Kaoru R.

In: Vascular and Endovascular Surgery, Vol. 43, No. 1, 02.2009, p. 30-45.

Research output: Contribution to journalArticle

Leon, Luis R. ; Glazer, Evan S. ; Hughes, John D ; Bui, Trung D. ; Psalms, Shemuel B. ; Goshima, Kaoru R. / Aortoiliac aneurysm repair in kidney transplant recipients. In: Vascular and Endovascular Surgery. 2009 ; Vol. 43, No. 1. pp. 30-45.
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