FATE OF RENAL-ALLOGRAFTS CONNECTED TO VASCULAR PROSTHESES

Objective: The outcome of renal transplantation with an arterial anast omosis to a vascular prosthesis in the aortofemoral tract is evaluated . Patients and Methods. All 7 Dutch transplant centers were invited to review their experience. Among a total of 5791 cadaveric renal transp lantations performed between 1978 and 1994, 13 cases (0.2%) in 3 diffe rent centres were identified. In 6 cases the vascular reconstruction a nd transplant operation were performed simultaneously, and in 7 cases separately, with a mean interval of 3.5 yr. The indications for vascul ar reconstruction were aneurysmal disease in 4 and obstructive disease in 9 cases. Results: The early vascular complications of these proced ures were hemorrhage in 4 and renal vein thrombosis in 1 and led to gr aft loss in 3 cases. The perioperative mortality was 2/13 (15%). The g raft and patient survival were 68 and 83% respectively after 1 yr and 17 and 37% after 5 yr. Late mortality was mainly due to cardiovascular disease. Conclusions: Renal transplantation with an arterial anastomo sis to a vascular prosthesis in the aortofemoral tract is a hazardous procedure with relatively poor short- and long-term results. These obs ervations shoud be considered in the choice of renal replacement thera py in this special patient population.