Resection of the abdominal aorta aneurysm in a patient with a transplanted kidney

The number of kidney transplants in patients with end-stage chronic renal disease is annually increasing all over the world. But the incidence of abdominal aorta aneurysm in patients with allografted kidney can be assessed from very few published reports. D.C.Cron et al revealed 29 cases of aorta aneurysm among 2133 patients who underwent kidney transplantation, thus the incidence making 1.35%. Surgery for abdominal aorta aneurysm in this patient population still remains a rarity in the practice of a vascular surgeon and so puts a number of fundamental questions for us that do not have ready-published answers. In heterotopic transplantation, the kidney ischemia during aortic cross-clamping is a crucial aspect in the treatment of this patient population, and if underestimated, it can potentially lead to the graft loss. A number of authors do not consider an additional protection of the kidney to be obligatory during the aortic crossclamping, and they believe the surgery can be performed safely for the graft by using a quick suture of the prosthesis. Below we present our clinical case report of the infra-renal aorta aneurysm resection without a graft protection in a patient after heterotopic kidney transplantation.