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• W2995917823 abstract "Introduction: One of the alternatives to increase the number of candidates for kidney transplantation (KT) is the use of expanded criteria for donor kidneys1 (defined as age > 60 years or between 51 and 59 years with two of three of the following risk factors: hypertension, creatinine serum > 1,5 mg/dl or cerebrovascular stroke death). This involves including aged kidneys that often associate arterial pathology in the vascular pedicle, as well as choosing recipients according to these kidneys, which are likely to present arterial disease. Under these conditions, we analyzed the role of vascular surgeon in KT program in our Hospital, both in the assessment of possible recipient patients, as well as in the donor kidney and implant surgery. Methods: Retrospective analysis of prospective collected series. From November 1996 to March 2018, 1625 patients who were candidates for a KT were evaluated, performing 1030 transplants, 42 of wich was dual (en-bloc) kidney transplant. The average age of donors (excluding en-bloc kidneys) (54.7 years ± 16.7 (r: 3-87)) and recipients (52.7 years ± 12.8 (r: 19-78)) was higher than the usual mean. The 66% of the donor kidneys had expanded criteria. 651 vascular repairs were performed on the pedicle of the donor kidney. The 6% of the recipients were older than 70 years. Nine recipients required iliac artery endarterectomy during the implant surgery, three interposition of PTFE graft between common and external iliac artery, and one aortobiiliac bypass.The results were analyzed using Kaplan-Meier tables determining the graft and patient survival. Results: The mean follow-up was 85.9 months (sd± 68.5 (r:0-251.7)). There were no ischemic complications after KT in the recipient. Graft survival at 1, 5 and 10 years was 89,7%, 79,5% and 63% respectively. Out of 353 failed grafts, 23 cases of venous thrombosis were identified (6,51%), and 10 cases of arterial thrombosis (2,83%). Patient survival at 1, 5 and 10 years was 98%, 92% and 85% respectively. Conclusion: The presence of vascular disease in donors and recipients for kidney transplantation involves the repair of many arterial and venous anomalies and injuries, requiring a refined vascular surgical technique. All this, together with the results obtained in our series, make it advisable to integrate vascular surgery units in kidney transplant programs. References(1)Metzger R, Delmonico F, Feng S et al. Expanded criteria donors for kidney transplantation. Am J Transplant 2003; 3: 114-125." @default.
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• W2995917823 date "2019-12-01" @default.
• W2995917823 modified "2023-09-27" @default.
• W2995917823 title "Do You Need a Vascular Surgeon Within the Kidney Transplant Program?" @default.
• W2995917823 doi "https://doi.org/10.1016/j.ejvs.2019.06.1126" @default.
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