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Aortoiliac aneurysm repair in kidney transplant recipients. | LitMetric

Aortoiliac aneurysm repair in kidney transplant recipients.

Vasc Endovascular Surg

Department of Vascular Surgery, Southern Arizona Veteran Affairs Health Care System (SAVAHCS), Tucson, Arizona 85723, USA.

Published: April 2009

AI Article Synopsis

  • The study investigates outcomes in kidney transplant patients undergoing endovascular aortic aneurysm repair (EVAR) versus open repair, particularly focusing on the impact on renal function.
  • In the EVAR group, kidney function remained stable post-surgery, showing no significant differences in creatinine levels, despite not using protective perfusion measures for the kidney allograft.
  • Both surgical techniques demonstrated excellent renal preservation and similar complication rates, indicating that EVAR without additional protective measures is as effective as open surgery for these patients.

Article 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.

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Source
http://dx.doi.org/10.1177/1538574408322654DOI Listing

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