Bad Aortoiliac Vessels: Not a Contraindication for Renal Transplantation

Studies on aortoiliac reconstruction for diseased vessels and renal transplantation are limited. We report a rare experience in reconstruction of aortobifemoral bypass using polytetrafluoroethylene (PTFE) vascular graft, along with a side limb graft for the donor artery in living kidney transplantation. A 44-year-old male, with autosomal dominant polycystic kidney disease on dialysis, needing transplantation, was found to have diseased aortoiliac vessels with tight stenosis at the aortic bifurcation during workup for renal transplantation. The anastomosis of the donor renal artery to the native iliac vessel was a surgical challenge with risk of hypoperfusion to renal graft as well as subsequent lower-limb ischemia. Hence, we went ahead with aortobifemoral bypass using PTFE vascular graft and anastomosis of the donor renal artery to a side limb graft from the main graft. Posttransplantation, he had stable normal renal allograft function at 1-year follow-up.