J Korean Med Sci.  2009 Feb;24(1):166-169. 10.3346/jkms.2009.24.1.166.

Abdominal Aortic Aneurysm Repair in Patient with a Renal Allograft: A Case Report

• Kim HK
• Ryuk JP
• Choi HH
• Kwon SH
• Huh S

• KMID: 1794426
• DOI: http://doi.org/10.3346/jkms.2009.24.1.166

Abstract

Renal transplant recipients requiring aortic reconstruction due to abdominal aortic aneurysm (AAA) pose a unique clinical problem. The concern during surgery is causing ischemic injury to the renal allograft. A variety of strategies for protection of the renal allograft during AAA intervention have been described including a temporary shunt, cold renal perfusion, extracorporeal bypass, general hypothermia, and endovascular stent-grafting. In addition, some investigators have reported no remarkable complications of the renal allograft without any specific measures. We treated a case of AAA in a patient with a renal allograft using a temporary aortofemoral shunt with good result. Since this technique is safe and effective, it should be considered in similar patients with AAA and previously placed renal allografts.

Keyword

Aortic Aneurysm, Abdominal; Renal Allograft, Temporary Shunt

MeSH Terms

Adult
Aortic Aneurysm, Abdominal/diagnosis/pathology/*surgery
Blood Vessel Prosthesis Implantation/methods
Graft Survival
Humans
Kidney/blood supply
*Kidney Transplantation
Male
Reperfusion Injury/prevention & control
Tomography, X-Ray Computed
Transplantation, Homologous

Figure

• 

  Fig. 1 CT angiographic images revealing (A) right pelvic renal allograft and (B) 6.4 cm sized infrarenal AAA.

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  Fig. 2 Temporary aortofemoral shunt from the perirenal aorta to the right femoral artery, allowing perfusion of the pelvic renal allograft during aortic cross-clamping.

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  Fig. 3 CT angiographic image showing a well-functioning aortic graft and a renal allograft.

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