Treatment of Common Iliac Arteries in Preparation for Kidney Transplant, What Is the Evidence? A 5-Year Review in One Institution

Abstract

Renal transplantation remains the treatment of choice for end stage renal disease, offering vastly improved survival and morbidity compared to chronic dialysis treatment. Peripheral arterial disease is much more common in patients with chronic kidney disease compared to the general population. Unrecognized peripheral artery disease, particularly aortoiliac disease, prior to kidney transplantation can result in significant complications including renal artery stenosis, anastomosis failure, graft loss, and even limb loss. In this presentation, we will review the literature on the pre-transplant evaluation and intervention of aortoiliac disease. We will also present two cases to illustrate the importance of an appropriate vascular evaluation prior to transplant. One case demonstrates successful recognition and treatment of common iliac artery stenosis prior to transplant, and one case demonstrates the disastrous consequence of failing to recognize aortoiliac disease.