Brent Taiting Xia
1, Aleksandr Aleksandrovich Reznichenko
1, Madison Colyn Cuffy
1*, Ervin Steve Woodle
11 Department of Surgery, Division of Transplantation, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Abstract
Background: Pseudoaneurysm after renal transplantation is a rare but serious complication.
Case Presentation: We report a case of a 76-year-old man who presented six weeks after kidney
transplant with a large pseudoaneurysm arising from the renal artery anastomosis, causing renal
vein compression and renal allograft dysfunction. Prior to the removal of the transplanted kidney,
an in situ cold perfusion of the allograft was performed. The pseudoaneurysm was repaired ex vivo
and the renal artery was reconstructed. External iliac vein was reconstructed with deceased donor
interposition allograft, and the kidney was then re-implanted. The patient recovered with immediate
allograft function.
Conclusions: Successful surgical management of a large renal allograft arterial pseudoaneurysm
involves avoidance of dissection of the pseudoaneurysm, utilization of in situ cold perfusion and
en-bloc removal of the kidney together with pseudoaneurysm, and pseudoaneurysm incision and
vascular bypass reconstruction ex vivo
Implication for health policy/practice/research/medical education:
Following renal transplant, the development of arterial pseudoaneurysm may result in significant morbidity and mortality. In
this case report of a patient who developed a large allograft arterial pseudoaneurysm six weeks after transplant that resulted
in allograft dysfunction, we demonstrate successful surgical management, resulting in patient recovery and allograft function.
Physicians and surgeons should be aware of this rare complication as a differential to the presentation of allograft dysfunction,
and the important principles and techniques used in repairing this challenging scenario.
Please cite this paper as:Xia BT, Reznichenko AA, Cuffy MC, Woodle ES. Treatment of large renal allograft arterial pseudoaneurysm
with in situ cold perfusion, ex vivo vascular reconstruction and re-implantation. J Nephropathol. 2019;8(1):e10. DOI:
10.15171/jnp.2019.10.