Moon I S, Park S C, Kim S N, Koh Y B
Department of Surgery, College of Medicine, The Catholic University of Korea, Kangnam St. Mary's Hospital, #505 Banpo Dong, Seocho Gu, Seoul, Korea 137-040.
Transplant Proc. 2006 Sep;38(7):2022-4. doi: 10.1016/j.transproceed.2006.06.108.
Renal transplant recipients currently survive many years with a consequent increase in the risk of presentation with vascular diseases. So aortic reconstruction in transplant patients has been increasingly reported the most common procedures involving abdominal aorta aneurysms (AAAs). The most important problem during the operation is ischemic injury to the transplanted kidney during aortic clamping. Protection for the grafted kidney from ischemic or reperfusion injury may be achieved by permanent or temporary axillo-femoral, femoro-femoral, aorto-iliac bypass, cold perfusion, local cold preservation, or autotransplantation. Some authors have reported protection of the transplanted kidney function without any other procedures. We had experience with four AAA cases in kidney transplant patients, including two cases of direct reconstruction of the AAA without any other surgical protection, one autotransplantation, and one AAA excision with using temporary aortofemoral bypass with good results. Herein, we report two cases of successful AAA excision without a surgical procedure for graft protection.
肾移植受者目前可存活多年，随之而来的是患血管疾病风险的增加。因此，越来越多关于移植患者主动脉重建的报道，其中涉及腹主动脉瘤（AAA）的最常见手术。手术期间最重要的问题是主动脉钳夹期间移植肾的缺血性损伤。通过永久性或临时性腋-股、股-股、主动脉-髂动脉旁路移植、冷灌注、局部低温保存或自体移植，可以实现对移植肾的保护，使其免受缺血或再灌注损伤。一些作者报道了无需任何其他手术即可保护移植肾功能。我们有4例肾移植患者AAA病例的经验，包括2例直接重建AAA且无任何其他手术保护措施的病例、1例自体移植病例以及1例使用临时性主动脉-股动脉旁路移植进行AAA切除的病例，效果良好。在此，我们报告2例成功切除AAA且未采取保护移植物手术的病例。
