Oelschlaeger Markus, Sokolakis Ioannis, Kalogirou Charis, Frey Lea, Riedmiller Hubertus, Kübler Hubert, Kellersmann Richard, Vergho Daniel
Department of Urology and Pediatric Urology, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany.
Urol Int. 2018;101(2):236-239. doi: 10.1159/000481101. Epub 2017 Oct 6.
Saphenous vein graft (SVG) aneurysms (SVGA) after renal transplantation represents a rare vascular complication with subsequent challenging multidisciplinary treatment. We present a case of a 30-year-old female who received a live donor kidney transplantation for end-stage renal disease that was caused due to the hemolytic uremic syndrome. Postoperatively, an insufficient graft perfusion due to an arterial kinking was noted and repaired using an autologous SVG interposition. Ten years later, a 3-cm aneurysm of the SVG at the anastomotic site with the common iliac artery was discovered. Multidisciplinary surgical exploration with excision of the aneurysm-carrying vein graft and interposition of a new autologous SVG was successfully carried out with preservation of renal allograft's function. Treatment of SVGA after rental transplantation with a new autologous SVG is challenging but feasible, requiring a multidisciplinary approach in order to guarantee successful rates and to prevent allograft loss.
肾移植后大隐静脉移植物（SVG）动脉瘤（SVGA）是一种罕见的血管并发症，后续多学科治疗颇具挑战性。我们报告一例30岁女性，因溶血性尿毒症综合征导致终末期肾病，接受了活体供肾移植。术后发现因动脉扭结导致移植物灌注不足，并使用自体SVG间置进行了修复。十年后，在与髂总动脉吻合部位发现了一个3厘米的SVG动脉瘤。成功进行了多学科手术探查，切除携带动脉瘤的静脉移植物并置入新的自体SVG，同时保留了同种异体肾的功能。用新的自体SVG治疗肾移植后的SVGA具有挑战性但可行，需要多学科方法以确保成功率并防止同种异体肾丢失。
