Endovascular Repair of Abdominal Aortic Aneurysms in Patients with Chronic Allograft Nephropathy

Abstract

Long-term survivors following renal transplantation may get abdominal aortic aneurysms (AAA) requiring operative intervention. Conventional open AAA repair necessitates a period of warm ischaemia to a renal transplant, and renoprotective manoeuvres are often inadequate. The introduction of endovascular strategies may represent a minimised risk method to repair the aneurysm. We report endovascular stenting of asymptomatic AAAs in two male patients with functioning renal transplants. Both patients had significant cardiovascular co-morbidity and chronic allograft nephropathy. Preoperative management included intravenous hydration and oral N-acetylcysteine. Both patients remained on immunosuppressant medication throughout. Following successful repair, these patients recovered without complication. Postoperative biochemical renal function returned to baseline in both cases. We conclude that endovascular repair of an AAA is a good surgical option for those with functioning renal allografts.