Aortoiliac reconstruction and renal transplantation: staged or simultaneous.

Aortoiliac atherosclerosis can jeopardize the outcome of renal transplantation. During a five-year period, 176 renal transplants were performed. Of these, four patients underwent prior or simultaneous arterial reconstruction. In two, transplantation was successfully performed three and ten months after abdominal aortic aneurysm repair. In the two others with aortoiliac occlusive lesions, simultaneous arterial reconstruction and transplantation were successfully performed. We conclude that the discovery of aortoiliac lesions in a candidate for renal transplantation warrants consideration for staged or simultaneous arterial reconstruction to widen the indications for transplantation in such individuals and provide satisfactory long-term transplant durability.