Use of an extracorporeal bypass for renal preservation to treat a rare case of a true mycotic aneurysm in a renal transplant patient

Enjae Jung MD , Francis J. Caputo MD , Jeffrey Jim MD
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Abstract

True mycotic aneurysms of the abdominal aorta are extremely rare after organ transplantation. We report a renal transplant recipient who presented with Pseudomonas aeruginosa bacteremia and a new saccular infrarenal aortic aneurysm. A temporary extracorporeal axillofemoral bypass was placed to maintain perfusion to the transplant kidney. A contained rupture was found, and excision and in-line reconstruction were performed using a cryopreserved human aortic allograft. At 3 years, the patient remained well, with normal renal function while on oral antibiotic suppressive therapy. Use of an extracorporeal bypass was a viable technique with minimal morbidity for renal transplant preservation during open aortic replacement.

应用体外旁路移植术保存肾脏,治疗肾移植患者罕见的真性真菌性动脉瘤
器官移植后发生腹主动脉真性真菌性动脉瘤极为罕见。我们报告一个肾移植受者谁提出了铜绿假单胞菌菌血症和新的囊性肾下主动脉瘤。放置临时体外腋股旁路以维持移植肾的灌注。发现了一个包含破裂,切除并使用冷冻保存的人主动脉异体移植物进行在线重建。3年,患者保持良好,在口服抗生素抑制治疗期间肾功能正常。使用体外旁路是一种可行的技术,在开放主动脉置换术中保留肾移植的发病率最低。
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