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Case Reports in Transplantation
Volume 2016, Article ID 6579591, 3 pages
http://dx.doi.org/10.1155/2016/6579591
Case Report

Preserved Renal Function in Kidney Transplantation over a Thrombosed Aortobifemoral Bypass Graft: The Role of Retrograde Flow and Early Thrombolysis

1Department of Nephrology, Hospital Universitario Ramón y Cajal, Carretera de Colmenar Viejo Km. 9.100, 28034 Madrid, Spain
2Department of Medicine, Universidad de Alcalá, 28805 Madrid, Spain
3Department of Radiology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
4Department of Vascular Surgery, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain

Received 29 May 2016; Accepted 14 July 2016

Academic Editor: Marian Klinger

Copyright © 2016 Saúl Pampa-Saico et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aortobifemoral bypass (ABFB) thrombosis is not uncommon, and when the artery of a renal graft is implanted on a bypass the risk of graft loss is high. We report the case of a 48-year-old woman with a previous history of ABFB under antiplatelet therapy and a kidney allograft implanted on the vascular prosthesis, who presented with acute limb ischemia and severe renal impairment. Imaging techniques revealed a complete thrombosis of the proximal left arm of the ABFB. However, a faint retrograde flow over the graft was observed thanks to the recanalization of distal left bypass by collateral native arteries. This unusual situation not previously reported in a kidney transplant setting, together with an early diagnosis, allowed graft survival until an early local thrombolysis resolved the problem. Two years later, renal function remains normal.