Renal transplantation in the older recipient has become commonplace. As the age range continues to widen, it is inevitable that one encounters age-related complications in this group, particularly that of advanced atherosclerosis. Lit erature regarding the management of patients with a previously transplanted kidney requiring proximal arterial replacement is available; however, manage ment strategies of acute inflow abnormalities during transplantation is lacking. The authors describe the identification, treatment, and outcome of a patient with acute ischemia of a newly transplanted kidney and ipsilateral extremity runoff, as a direct result of inflow abnormalities.
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