Abstract

Background: Atherosclerosis is common in end stage renal failure patients
on dialysis. On the other hand it was considered a contraindication for kidney transplantation. Nowadays, extended indications are accepted on the waiting list including patients with severe atherosclerosis. This requires vascular procedure prior or during kidney transplantation. The aim of the study was to present our experience with vascular reconstruction prior to kidney transplantation.
Material/Methods: There were ten atherosclerotic, uremic patients referred to our Department as candidates for kidney transplantation. All were refused waiting list inclusion due to occlusive lesions of iliac arteries or distal part of the aorta. There were 9 male and 1 female, age 45-68 years. Preoperative assessment consisted of Doppler ultrasound and angio-CT scan. Reconstruction was performed with aorto-bi-iliac in 6, aorto-bi-femoral in 3 and ilio-femoral Dacron graft in 1 patient under general anaesthesia.
Results: There were no major postoperative complications. Patients were discharged and placed on a special waiting list. Six of them received kidney allograft including one living-related transplantation. All procedures were made with transplanted kidney artery anastomosis to the side of the prosthesis. No patient developed signs of arterial graft infection. In postoperative period there was no arterial or transplanted kidney related complications, except delayed graft function in 2 cases. Remaining four patients are still on the waiting list.
Conclusions: Vascular reconstruction in end-stage renal failure patients with
severe atherosclerosis of aorto-iliac vessels allows kidney transplantation.

Keywords: Kidney Transplantation