Mycotic aneurysms in transplant patients

G. K. Kyriakides, R. L. Simmons and J. S. Najarian

Eight cases of mycotic aneurysm occurred in seven transplant patients. Perinephric wound infection involving the iliac arteries was the cause of at least seven aneurysms. Simple ligation of the iliac artery proximal and distal to the aneurysm without grafting was effective therapy in all but one patient with an aortic aneurysm who required an axillofemoral bypass graft prior to excision of the aneurysm. There were no instances of ischemia to the involved extremities, and only two patients died as a result of the aneurysm. This dangerous complication can be avoided by preventing wound infections. In established perinephric abscesses, the kidney should be removed and the wound kept as clean as possible in order to prevent this complication. Arteriograms may be useful in the early detection of these aneurysms, before they rupture.