vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2012-2-49-56vtio-163Research ArticleКлинические наблюденияClinical CasesРАЗРЫВ АНЕВРИЗМЫ БРЮШНОЙ АОРТЫ У ПАЦИЕНТА С ПОЧЕЧНЫМ АЛЛОТРАНСПЛАНТАТОМRUPTURE OF ABDOMINAL AORTIC ANEURYSM IN RENAL TRANSPLANT PATIENTФадинБ. В.FadinB. V.ЛещенкоИ. Г.LesсhenkoI. G.РжанниковВ. В.RzhannikovV. V.АндреевВ. В.AndreevV. V.ГасниковА. В.GasnikovA. V.ГасниковА. А.GasnikovA. A.КостенецкийА. В.KostenetskiyA. V.СаблинИ. В.SablinI. V.ГБУЗ «Свердловская областная клиническая больница No 1», г. ЕкатеринбургSverdlovsk Regional Hospital No 1, EkaterinburgГБУЗ «Свердловская областная клиническая больница No 1», г. Екатеринбург201228052014142ВЕСТНИК ТРАНСПЛАНТОЛОГИИ И ИСКУССТВЕННЫХ ОРГАНОВ том XIV No 2–20124956Copyright © Фадин Б.В., Лещенко И.Г., Ржанников В.В., Андреев В.В., Гасников А.В., Гасников А.А., Костенецкий А.В., Саблин И.В., 20122012Фадин Б.В., Лещенко И.Г., Ржанников В.В., Андреев В.В., Гасников А.В., Гасников А.А., Костенецкий А.В., Саблин И.В.Fadin B.V., Lesсhenko I.G., Rzhannikov V.V., Andreev V.V., Gasnikov A.V., Gasnikov A.A., Kostenetskiy A.V., Sablin I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/163

Цель настоящего сообщения – описание клинического случая протезирования разрыва аневризмы брюш- ной аорты у пациента 55 лет с почечным аллотрансплантатом. Для реабилитации пациента потребовалось 15 суток, при контрольной мультиспиральной компьютерной томографии анастомозы протеза с аортой конгруэнтны, перфузия артериального русла нижних конечно- стей и почечного трансплантата адекватны. Разрыв аневризмы аорты у пациента с пересаженной почкой является сложной клинической проблемой, когда спасение жизни пациента и судьба пересаженной почки нередко находятся в антагонизме. 

The purpose of this article was to report our first experience in surgical treatment of aortic aneurism rupture in patient of 55 years old with renal transplant. Aortic aneurism rupture always associated with high mortality, and urgent operative procedure is also rather complicative and has also in bad anatomical conditions. The expectation of good collateral circulation for renal transplant, quick cross-clamp time and easy graft replacement may not always be the case. We believe that trans- planted kidney should be protected when ever feasible, especially in urgent procedure. 

аневризма аортыразрывтрансплантат почкигипотермическая перфузияаortic aneurismrupturerenal transplantcold perfusionReferencesКазанчян П.О., Попов В.А. Осложнения в хирургии аневризмы аорты М.: МЭИ, 2002. 304 с.Казанчян П.О., Попов В.А. Осложнения в хирургии аневризмы аорты М.: МЭИ, 2002. 304 с.Жидкова Д.А., Томилина Н.А., Семеновский М.Л. и др. Расслаивающая аневризма аорты у реципиента аллогенной почки // Нефрология и диализ. 2006. Т. 8, No 1. С. 78–84.Жидкова Д.А., Томилина Н.А., Семеновский М.Л. и др. Расслаивающая аневризма аорты у реципиента аллогенной почки // Нефрология и диализ. 2006. Т. 8, No 1. С. 78–84.Спиридонов А.А., Тутов Е.Г., Аракелян В.С. Хирурги- ческое лечение аневризмы брюшной аорты. М.: Изд- во НЦССХ им. А.Н. Бакулева РАМН, 2000. 206 с.Спиридонов А.А., Тутов Е.Г., Аракелян В.С. Хирурги- ческое лечение аневризмы брюшной аорты. М.: Изд- во НЦССХ им. А.Н. Бакулева РАМН, 2000. 206 с.Kim H.K., Ryuk J.P., Choi H.H., Kwon S.H., Huh S. Ab- dominal aortic aneurysm repair in a patient with a re- nal allograft: a case report // J. Korean Med. Sci. 2009. Vol. 24. P. 166–169.Kim H.K., Ryuk J.P., Choi H.H., Kwon S.H., Huh S. Ab- dominal aortic aneurysm repair in a patient with a re- nal allograft: a case report // J. Korean Med. Sci. 2009. Vol. 24. P. 166–169.Norwood M.G.A., Polimenovi N.M., Sutton A.J., Bown M.J., Sayers R.D. Abdominal aortic aneurysm repair in pati- ents with chronic renal disease // Eur. J. Vasc. Endovasc. Surg. 2004. Vol. 27. P. 287–291.Norwood M.G.A., Polimenovi N.M., Sutton A.J., Bown M.J., Sayers R.D. Abdominal aortic aneurysm repair in pati- ents with chronic renal disease // Eur. J. Vasc. Endovasc. Surg. 2004. Vol. 27. P. 287–291.Sidhn R.S., Lindsay T.F., Rubin B., Walker P.M., Kal- man P., Johnston K.W. Aortic and iliac reconstruction af- ter kidney transplantation: experience with an algorithm for renal protection // Ann. Vasc. Surg. 2003. Vol. 17. No 2. P. 165–170.Sidhn R.S., Lindsay T.F., Rubin B., Walker P.M., Kal- man P., Johnston K.W. Aortic and iliac reconstruction af- ter kidney transplantation: experience with an algorithm for renal protection // Ann. Vasc. Surg. 2003. Vol. 17. No 2. P. 165–170.Matia I., Adamec M., Janousek L., Lipar K., Viklicky O. Aortoiliac reconstruction with allograft and kidney trans- plantation as a one-stage procedure: long term results // Eur. J. Vasc. Endovasc. Surg. 2008. Vol. 35. P. 353–357.Matia I., Adamec M., Janousek L., Lipar K., Viklicky O. Aortoiliac reconstruction with allograft and kidney trans- plantation as a one-stage procedure: long term results // Eur. J. Vasc. Endovasc. Surg. 2008. Vol. 35. P. 353–357.Campbell D.A. Renal transplant protection during abdo- minal aortic aneurysmectomy with a pump-oxigenator / D.A. Campbell, M.I. Lorber, W.A. Arneson // Surgery. 1981. Vol. 90. P. 559–562.Campbell D.A. Renal transplant protection during abdo- minal aortic aneurysmectomy with a pump-oxigenator / D.A. Campbell, M.I. Lorber, W.A. Arneson // Surgery. 1981. Vol. 90. P. 559–562.Ailawadi G., Bedi A., Williams D.M., Stanley J.C., Up- church G.R. Endovascular treatment of aortic aneurysms in patients with renal transplants // J. Vasc. Surg. 2003. Vol. 37. P. 693–696.Ailawadi G., Bedi A., Williams D.M., Stanley J.C., Up- church G.R. Endovascular treatment of aortic aneurysms in patients with renal transplants // J. Vasc. Surg. 2003. Vol. 37. P. 693–696.Florack G. Definition of normothermic ischemic limits for kidney and pancreas grafts / G. Florack, D.E. Suther- land, R. Ascherl // J. Surg. Res. 1986. Vol. 40. P. 550–563.Florack G. Definition of normothermic ischemic limits for kidney and pancreas grafts / G. Florack, D.E. Suther- land, R. Ascherl // J. Surg. Res. 1986. Vol. 40. P. 550–563.Geroulakas G. Infrarenal abdominal aortic aneurysm less than five centimeters in diameter: the surgeon’s dilemma / G. Geroulakas, A. Nimpedes // Eur. J. Vasc. Surg. 1992. Vol. 6. P. 616–622.Geroulakas G. Infrarenal abdominal aortic aneurysm less than five centimeters in diameter: the surgeon’s dilemma / G. Geroulakas, A. Nimpedes // Eur. J. Vasc. Surg. 1992. Vol. 6. P. 616–622.Hak E. Abdominal aortic aneurysm screening: an epide- miological point of view / E. Hak, R. Balm, B.C. Eikel- boom // Eur. J. Vasc. Endovasc. Surg. 1996. Vol. 11. No 3. P. 270–278.Hak E. Abdominal aortic aneurysm screening: an epide- miological point of view / E. Hak, R. Balm, B.C. Eikel- boom // Eur. J. Vasc. Endovasc. Surg. 1996. Vol. 11. No 3. P. 270–278.Harris J.P. Successful aortic surgery after renal transplan- tation without protection of a transplanted kidney / J.P. Harris, J. May // J. Vasc. Surg. 1987. Vol. 5. P. 457–461.Harris J.P. Successful aortic surgery after renal transplan- tation without protection of a transplanted kidney / J.P. Harris, J. May // J. Vasc. Surg. 1987. Vol. 5. P. 457–461.Lacombe M. Abdominal aortic aneurysmectomy in re- nal transplant patients / M. Lacombe // Ann. Surg. 1986. Vol. 203, No 1. Р. 62–68.Lacombe M. Abdominal aortic aneurysmectomy in re- nal transplant patients / M. Lacombe // Ann. Surg. 1986. Vol. 203, No 1. Р. 62–68.Lacombe M. Aortoiliac surgery in renal transplant patients / M. Lacombe // J. Vasc. Surg. 1991. Vol. 13. P. 712–718.Lacombe M. Aortoiliac surgery in renal transplant patients / M. Lacombe // J. Vasc. Surg. 1991. Vol. 13. P. 712–718.Lacombe M. Surgical treatment of aortoiliac aneurysms in renal transplant patients / M. Lacombe // J. Vasc. Surg. 2008. Vol. 48. P. 291–295.Lacombe M. Surgical treatment of aortoiliac aneurysms in renal transplant patients / M. Lacombe // J. Vasc. Surg. 2008. Vol. 48. P. 291–295.Lacombe M. Abdominal aortic aneurysmectomy in re- nal transplant patients / M. Lacombe // Ann. Surg. 1986. Vol. 203, No 1. P. 62–68.Lacombe M. Abdominal aortic aneurysmectomy in re- nal transplant patients / M. Lacombe // Ann. Surg. 1986. Vol. 203, No 1. P. 62–68.Maeda T. Abdominal aortic aneurysm repair in a renal transplant recipient using a femoral V-A bypass / T. Ma- eda, N. Watanabe, S. Muraki // Ann. Thorac. Cardiovasc. Surg. 2009. Vol. 15, No 6. P. 415–417.Maeda T. Abdominal aortic aneurysm repair in a renal transplant recipient using a femoral V-A bypass / T. Ma- eda, N. Watanabe, S. Muraki // Ann. Thorac. Cardiovasc. Surg. 2009. Vol. 15, No 6. P. 415–417.Morris G.C. The protective effect of subfiltration arte- rial pressure on the kidney / G.C. Morris, C.F. Heider, J.H. Moyer // Surg. Forum. 1956. No 6. P. 623–624.Morris G.C. The protective effect of subfiltration arte- rial pressure on the kidney / G.C. Morris, C.F. Heider, J.H. Moyer // Surg. Forum. 1956. No 6. P. 623–624.Muluk S.C. Aortic aneurysm in heart transplant patients / S.C. Muluk, D.L. Steed, M.S. Makaroun, S.M. Pham, R.L. Kormos, B.P. Griffith // J. Vasc. Surg. 1995. Vol. 22. P. 689–696.Muluk S.C. Aortic aneurysm in heart transplant patients / S.C. Muluk, D.L. Steed, M.S. Makaroun, S.M. Pham, R.L. Kormos, B.P. Griffith // J. Vasc. Surg. 1995. Vol. 22. P. 689–696.Nashel D.J. Is atherosclerosis a complication of long- term corticosteroid treatment? / D.J. Nashel // Am. J. Med. 1986. Vol. 80. P. 925–929.Nashel D.J. Is atherosclerosis a complication of long- term corticosteroid treatment? / D.J. Nashel // Am. J. Med. 1986. Vol. 80. P. 925–929.Nevitt M.P. Prognosis of abdominal aortic aneurysms: a population based study / M.P. Nevitt, D.J. Ballard, J.W. Hallef // N. Engl. J. Med. 1989. Vol. 321. P. 1009– 1014.Nevitt M.P. Prognosis of abdominal aortic aneurysms: a population based study / M.P. Nevitt, D.J. Ballard, J.W. Hallef // N. Engl. J. Med. 1989. Vol. 321. P. 1009– 1014.Nghiem D.D. In situ hypothermic preservation of a re- nal allograft during resection of abdominal aortic an- eurysm / D.D. Nghiem, H.M. Lee // Am. Surg. 1982. Vol. 48. P. 237–238.Nghiem D.D. In situ hypothermic preservation of a re- nal allograft during resection of abdominal aortic an- eurysm / D.D. Nghiem, H.M. Lee // Am. Surg. 1982. Vol. 48. P. 237–238.Piotrowski J.J. Abdominal aortic aneurysm in the pa- tient undergoing cardiac transplantation / J.J. Pio- trowski, K.E. Mc Intyre, G.C. Hunter, C.S.K. Sethi, V.M. Bernard, J.C. Copeland // J. Vasc. Surg. 1991. Vol. 14. P. 460–467.Piotrowski J.J. Abdominal aortic aneurysm in the pa- tient undergoing cardiac transplantation / J.J. Pio- trowski, K.E. Mc Intyre, G.C. Hunter, C.S.K. Sethi, V.M. Bernard, J.C. Copeland // J. Vasc. Surg. 1991. Vol. 14. P. 460–467.Pittaluga P. Aortoiliac reconstruction and kidney trans- plantation: a multicenter study / P. Pittaluga, R. Hassen- Khodja, E. Cassuto-Viguier // Ann. Vasc. Surg. 1998. Vol. 12, No 2. P. 529–536.Pittaluga P. Aortoiliac reconstruction and kidney trans- plantation: a multicenter study / P. Pittaluga, R. Hassen- Khodja, E. Cassuto-Viguier // Ann. Vasc. Surg. 1998. Vol. 12, No 2. P. 529–536.Reilly J.M. Hydrocortisone rapidly induces aortic rup- ture in a genetically suspectible mouse / J.M. Reilly, E.B. Savage, C.H. Brophy, M.D. Tilson // Arch. Surg. Vol. 125. P. 707–709.Reilly J.M. Hydrocortisone rapidly induces aortic rup- ture in a genetically suspectible mouse / J.M. Reilly, E.B. Savage, C.H. Brophy, M.D. Tilson // Arch. Surg. Vol. 125. P. 707–709.Schwartz R.A. Successful repair of a ruptured abdo- minal aortic aneurysm in a renal transplant recipient / R.A. Schwartz, F.C. Bridget, G.J. Peterson // Ann. Vasc. Surg. 1988. Vol. 2, No 2. Р. 189–192.Schwartz R.A. Successful repair of a ruptured abdo- minal aortic aneurysm in a renal transplant recipient / R.A. Schwartz, F.C. Bridget, G.J. Peterson // Ann. Vasc. Surg. 1988. Vol. 2, No 2. Р. 189–192.Sterioff S. Temporary vascular bypass for perfusion of a renal transplant during abdominal aneurysmectomy / S. Sterioff, L. Parks // Surgery. Vol. 82. P. 558–560.Sterioff S. Temporary vascular bypass for perfusion of a renal transplant during abdominal aneurysmectomy / S. Sterioff, L. Parks // Surgery. Vol. 82. P. 558–560.Matia I., Pirk J., Lipar K., Adamec M. Successful surgi- cal treatment of multilevel aortic aneurysms combined with renal transplantation // J. Vasc. Surg. 2009. Vol. 50. P. 198–201.Matia I., Pirk J., Lipar K., Adamec M. Successful surgi- cal treatment of multilevel aortic aneurysms combined with renal transplantation // J. Vasc. Surg. 2009. Vol. 50. P. 198–201.Englesbe M.J., Wu A.H., Clowes A.W., Zierler R.E. The prevalence and natural history of aortic aneurysms in heart and abdominal organ transplant patients // J. Vasc. Surg. 2003. Vol. 37. P. 27–31.Englesbe M.J., Wu A.H., Clowes A.W., Zierler R.E. The prevalence and natural history of aortic aneurysms in heart and abdominal organ transplant patients // J. Vasc. Surg. 2003. Vol. 37. P. 27–31.UK Renal Registry Report, 2000.UK Renal Registry Report, 2000.

The authors declare that there are no conflicts of interest present.