Scenario 1 :
A 24 year old female patient on HD for the last 5 years after failure of her second transplantation due to CAN (Chronic Allograft Nephropathy) is keen to be considered for another kidney transplant. She still retains the failed grafts. She had many abdominal operations in the past (picture is below).
- What are your surgical options?
- Would your decision differ if one of the old kidneys were removed (graft nephrectomy)?
A 35 year old CKD5 due to reflux nephropathy was offered a suitable kidney from his father. During the routine work up, both femoral pulses were felt, but both legs were swollen with tender groins. CT angiogram demonstrated bilateral occlusion of external and common iliac veins just up to the level of the IVC (see below). Both iliac arteries and the aorta appeared normal on angiogram.
• What are the surgical options?
• Would your decision differ if both iliac arteris were calcified and not suitable as inflow vessels?