Technique

Technique: Arteriorarterial Bypass For Renal Transplant Protection During Abdominal Aortic Aneurysmectomy Using a Centrifugal Pump and Limited Heparinization

University of Pittsburgh Health Center, Pittsburgh, PA

^* Address correspondence to: M. Charlene Fabrizio, Peifusion Services Department, Children's Hospital of Pittsburgh, One Children's Place, Pittsburgh, PA 15213

Abstract

Today, renal transplant patients have increasing longterm success rates. Since the arteriosclerotic disease plaguing the renal patient seems to be more intensified after hemodialysis, expectations are that greater numbers of renal transplant patients with aortic disease will be seen.

When clamping of the aorta occurrs during aneurysmectomy, perfusion of the transplanted kidney is compromised. A Bio-Medicus [a] centrifugal pump was utilized in the repair of an abdominal aortic aneurysm to protect the transplanted renal graft. The bypass consisted of cannulated sites of the left axillary artery and the left femoral artery with the centrifugal pump unit interposed. The resulting bypass was considered to be an “in situ” perfusion of the kidney. A small amount of heparin was given. The transplanted kidney excreted urine the entire procedure; the creatinine levels remained stable, and the patient did well.

Successful use of this simple yet effective arterioarterial bypass lends itself to greater use in the future (J. Extra-Corpor. Technol., 21(2): 61-64, 1989, 11 Ref).