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[Aortoiliac surgery after renal transplantation. Authors' experience and review of the literature].

Eighteen patients who had undergone renal transplantation three months to 25 years earlier were operated on for treatment of complicated aortoiliac atherosclerosis: nine had aneurysms (of which one was leaking) and nine had stenotic or obstructive lesions. Except for the first patient, operated on in 1973, in whom the kidney was protected by general hypothermia, no special measure was used to protect the kidneys in the other 17 patients. A transient increase in creatininemia occurred in the majority of cases during postoperative period. All patients had regained renal function identical to the preoperative state in less than 10 days. Three patients had significant improvement of renal function which lasted in the long term follow-up. Such improvement was a result of correction of a lesion that was impairing renal blood flow. Results obtained in this series show that protection of the transplant during aortic surgery is not necessary, provided an adequate surgical technique is used. This technique is described: it avoids the complex methods employed in several previously reported cases and appears to be a safe procedure.