Kidney transplantation in diabetic recipients with iliac atherosclerosis(report of 51 cases) / 中华泌尿外科杂志

ABSTRACT

Objective To explore the techniques of renal transplantation in diabetic recipients with lilac atherosclerosis.Methods Overall,54 renal transplantations were performed in 51 diabetic recipients with lilac atherosclerosis.The renal arteries were end-side anastomosed to iliac arteries with atherectomy in 19 cases and without atherectomy in 13 cases,or end-end anastomosed to internal iliac arteries through titani- um stapler after atherectomy in 22 cases.Results Primary nonfunetion of renal allografts occurred in 3 cases due to poor blood perfusion of the renal grafts;delayed graft function occurred in 9 cases(17.6%), and the other 42 grafts functioned well immediately after transplantation.Two patients died of sudden cardiac arrest during the perioperative period.During a follow-up of 11-70 months,the 1-year and 3-year survival rates of recipients/grafts were 89.8%/87.8% and 84.4%/81.3% ,respectively.The main cause of graft loss was recipients' death with functioning graft.Conclusions The artery anastomosis of renal graft in di- abetic recipients with lilac atherosclerosis is difficult to perform.In order to achieve enough blood peffusion of the renal graft,it is important to select proper artery for anastomosis and to perform atherectomy.The recipi- ents with coronary artery disease should receive myocardial revascularization routinely before transplantation.