Aortoiliac reconstruction following renal transplantation.

With better survival and extended indications for renal transplantation, it is anticipated that the problem of aortoiliac disease in the posttransplant patient will be seen with increasing frequency. Two patients requiring aortoiliac reconstruction were successfully managed with improvement in graft function after surgery. One patient manifested atheroembolism resulting from aortoiliac occlusive disease; the other had a 2 cm rupture in an aortic aneurysm, which resulted in a large retroperitoneal hematoma, but without frank shock. Perfusion of the transplanted kidney was maintained by the use of a temporary axillofemoral graft, which was removed following aortoiliac repair. The use of this technique involves minimal physiologic disturbance to the patient and the renal graft and allows conventional aortoiliac reconstruction.