Abdominal aortic aneurysm repair in renal and liver transplant recipients.
Premaratne, Sobath Hopkins, Jonathan Duddy, Martin Tai, Ket Sang Kay, Mark Rogoveanu, Radu Nicholl, Phil Tiwari, Alok
Premaratne, Sobath
Hopkins, Jonathan
Duddy, Martin
Tai, Ket Sang
Kay, Mark
Rogoveanu, Radu
Nicholl, Phil
Tiwari, Alok
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2019-10-10
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Abstract
Background: Abdominal aortic aneurysm (AAA) repair in patients with organ transplant remains a challenge. We looked at AAA repair in patients with organ transplants at our tertiary liver and kidney transplant unit.
Methods: A retrospective analysis of a prospectively maintained database was undertaken from January 2008 to July 2018. We looked at patient demographics, type of repair, and technical success including reinterventions, perioperative transplant organ function, and 30-day and 1-year survival rate. Eight of 662 patients who underwent AAA repair had a solid organ transplant. Of these, 5 were kidney transplants, 2 liver transplants, and 1 had kidney and liver transplant; 75% were male; and average age was 63.4 (range: 49-83). All patients had asymptomatic AAAs, and 6 were treated with standard endovascular repair, 1 standard repair with iliac branch device, and 1 open repair. Adjunctive techniques such as CO2 angiograms, deployment of main body through contralateral iliac, low-profile sheaths, custom-made stent grafts, and temporary axillo-femoral shunting were used to protect transplant organs. Thirty-day survival was 100% with 1 death at 5 months from liver failure, and 1 patient has a persistent type-2 endoleak 3 years after the procedure.
Conclusion: Abdominal aortic aneurysm repair in patients with organ transplants can be undertaken using adjunctive endovascular and open surgical techniques.
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Premaratne S, Hopkins J, Duddy M, Tai KS, Kay M, Rogoveanu R, Nicholl P, Tiwari A. Abdominal Aortic Aneurysm Repair in Renal and Liver Transplant Recipients. Vasc Endovascular Surg. 2020 Jan;54(1):51-57. doi: 10.1177/1538574419880673. Epub 2019 Oct 10
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