ABDOMINAL AORTIC-ANEURYSM REPAIR IN A PATIENT WITH BILATERAL AUTOTRANSPLANTED KIDNEYS

The case is presented of a 38-year-old male who presented with a large 10 cm x 8 cm pulsatile swelling in his abdomen. Thirteen years before , internal iliac arteries had been used to treat long segment occlusio ns and diseased state of both renal arteries. At the same time both ki dneys had been transplanted to the iliac fossae. Digital subtraction a ngiography revealed a huge abdominal aortic aneurysm. Both kidneys wer e fully functional. As the renal transplants had been done extraperito neally an easy transperitoneal approach was now possible. The maximum diameter of the aneurysm was 12 cm. An inclusion graft repair was carr ied out using a 16-mm woven Dacron graft. In the light of the favourab le circumstances it was decided not to take any special protective mea sures against renal ischemia apart from keeping the aortic cross-clamp time short. The patient could be discharged with patent and normally functioning kidneys 10 days after surgery.