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21 May 2009

Mid-term results of endovascular treatment of abdominal aortic aneurysm in kidney transplant recipients

J Szmidt, Z Gałązka, O Rowiński, T Jakimowicz, M Durlik, Ł Romanowski, B Solonynko

Ann Transplant 2009; 14(1): 47-47 :: ID: 880369

Abstract

Background: The number of abdominal aortic aneurysms (AAA) in kidney
transplant recipients is increasing. Previously performed open aneurysmectomy is technically difficult and burdened with high risk of ischemic injury to transplanted kidney. The aim of the study was to assess the results of endovascular AAA treatment in kidney transplant recipients.
Material/Methods: Since 1998 endovascular treatment of AAA was performed in 665 patients in our Department. Eleven (1.65%) were kidney transplant recipients. Time between kidney transplantation and AAA management was 3 to 19 years. In 7 patients' graft's renal artery was anastomosed by end-to-end method to hypogastric artery, in remaining patients' end-to-side to external iliac artery. Bifurcated stent-grafts were implanted under epidural anaesthesia. All patients were followed-up with Doppler ultrasound or CT-scan performed according to Eurostar protocol. Kidney function was assessed two to four times a year.
Results: Successful AAA exclusion and preserved flow to transplanted kidney were confirmed on the final angiogram in all patients. Temporary deterioration of transplanted kidney function was observed in three patients, one of them required transient haemodialysis. In follow-up there was one stent-graft's limb thrombosis at 9 months after stent-graft's implantation that required femoro-femoral by-pass. In two patients there was endoleak type I treated successfully with proximal extension. The mean observation period was 34 months (range 3-80 months).
Conclusions: Endovascular treatment of AAA in kidney transplant recipients can be performed without major complications and serious deterioration of graft function. Thus this is a safe and effective method and can be considered as a treatment of choice.

Keywords: Kidney Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358