Effects of simultaneous Iliac artery angioplasty on graft and patient survival after living-donor kidney transplantation

BACKGROUND: Renal transplant candidates with extended indications, such as older age and advanced atherosclerosis, are currently accepted onto the waiting list. METHODS: We retrospectively evaluated the clinical outcomes of simultaneous kidney transplantation and angioplasty compared with transplantation alone. RESULTS: We included 748 patients who underwent living-donor kidney transplant because of end-stage renal disease during a 5-year period, consisting of 27 kidney transplants with simultaneous angioplasty and 721 without additional vascular procedures. As candidates for simultaneous angioplasty and transplant, we considered patients with TransAtlantic Inter-Society Consensus type A and B aorto-iliac disease. We compared transplant outcomes in patients who did or did not receive simultaneous angioplasty. Although simultaneous iliac artery angioplasty was significantly related to recipient age, diabetes mellitus, hypertension, and coronary artery disease, it was not associated with graft (uncensored, P=0.937; death censored, P=0.981) or patient (P=0.804) survival during the follow-up period. In addition, simultaneous angioplasty was not associated with a higher risk of delayed graft function (P=0.099) or a longer hospital stay (P=0.790). There was no significant difference in mortality due to a cardiovascular event between the two groups (P=0.199). CONCLUSIONS: Simultaneous iliac artery angioplasty and kidney transplantation in carefully selected patients can be performed safely with equivalent graft and patient survival to transplantation alone.