Kidney Transplantation in Patients with a Previous History of Femoral Lines: Surgical Challenges and Outcomes

Objectives

To assess surgical complexity, early complications, and short-term graft outcomes in kidney transplant recipients with a history of femoral lines. METHODOLOGY This prospective cohort study included 47 adult renal transplant recipients with prior femoral catheterisation who underwent living donor transplantation at the Institute of Kidney Diseases, Peshawar, Pakistan. Data on demographics, intraoperative events, and postoperative outcomes were analysed using SPSS (p < 0.05). Complications were classified by the Clavien–Dindo system. RESULTSRecipients had a mean age of 39.8 ± 10.7 years, and 80.9% were male. Hypertension (76.6%) and diabetes (25.5%) were common. All transplants were performed in the right iliac fossa, using the external iliac vessels in most cases. Difficult venous exposure occurred in 19.1%, and venous injury in 6.4%. Delayed graft function developed in 19.1%, while 6-month graft and patient survival were 91.5% and 97.9%, respectively. Patients with venous abnormalities had longer operative times and greater blood loss (p < 0.05) but similar graft survival

Conclusion

Kidney transplantation in patients with prior femoral lines is feasible and yields favourable early outcomes. Pre-operative vascular imaging, meticulous surgical technique, and multidisciplinary coordination are essential to mitigate intraoperative risks and optimise graft success.