Right renal vein elongation with the inferior vena cava for cadaveric kidney transplants: an old neglected surgical approach

Baptista-Silva, José Carlos Costa; Medina‐Pestana, José Osmar; Veríssimo, Marcos José Martins; Castro, Maria da Graça Tanori de; Demuner, Maris Salete; Signorelli, Marcio F.

doi:10.1590/s1677-55382005000600002

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…[8][9] These problems may lead to venous hemorrhage or thrombosis. 10 And renal vein thrombosis is a serious complication that can lead to graft nephrectomy, despite medical or surgical therapy. [4][5] First, clinicians should try to avoid damaging the transplanted kidney vein during surgery, which is more important than rebuilding the vein is.…”

Section: Discussionmentioning

confidence: 99%

“…Various techniques have been used including a vena cava patch, a venous saphenous autograft, a gonadal vein, and a cryopreserved external iliac artery allograft. 10,[12][13][14] Venous saphenous autograft is a good natural material, but the difference in the diameter of the venous vessel relative to the We re-formed the great saphenous vein to match the renal vein using the aforementioned method. And the kidney transplant surgery following was successful.…”

Section: Discussionmentioning

confidence: 99%

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Che

Li²,

Yang³

et al. 2016

Exp Clin Transplant

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Che

Li²,

Yang³

et al. 2016

Exp Clin Transplant

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“…The short length of the RRV and its thin wall make the venous anastomosis extremely challenging, especially in obese recipients, and may needlessly increase the rewarming time [3]. Additionally, the increase in the kidney size following reperfusion further reduces access to the hilum and area of anastomosis, making hemostasis very difficult.…”

Section: Introductionmentioning

confidence: 99%

“…Several techniques to reconstruct the RRV have been described in the literature, including IVC flaps, patches, conduits, and different means of stump closure [3][4][5][6][7][8][9]. We utilize the attached segment of IVC to lengthen the right renal vein by closing the 2 caval ends, with flexibility in the method of closure.…”

Section: Introductionmentioning

confidence: 99%

Right Renal Vein Augmentation in Deceased Donor Kidney Transplantation: Importance of the Contiguous Inferior Vena Cava

Khan¹,

Baig²,

Zahid³

et al. 2010

UIJ

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INTRODUCTION:The short, thin-walled right renal vein (RRV) makes anastomosis and hilar hemostasis challenging in deceased donor kidney transplantation. The right renal artery is twice the length of the vein. The purposes of the present retrospective study were to: (1) describe a surgical technique that uses the contiguous inferior vena cava (IVC) segment to lengthen the right renal vein, and (2) report the surgical outcomes. METHODS: A total of 44 right deceased-donor kidneys were transplanted into 44 recipients between March 2005and February 2010. Recipient ages ranged from 19-68 years (28 females; 16 males). We used the contiguous IVC to augment short renal veins in the right kidney allografts. This resulted in a horizontal extension of the RRV, with outflow through the orifice of the left renal vein (LRV). Augmented right renal veins were anastomosed end-toside to the external iliac vein, and the right renal arteries with aortic patches were anastomosed end-to-side to the external iliac artery in all recipients except 1. Surgical outcomes were assessed. RESULTS:Among the 44 kidney recipients, 39 were first transplants and 5 were second transplants. The kidneys were placed on the right side (n = 38), left side (n = 5), and into the peritoneum (n = 1). The mean RRV augmentation time was 32 minutes (range, 24-49 minutes); completion of back-table dissection added another 40 minutes. The cold ischemia times ranged from 3 hours 50 minutes to 19 hours. The rewarming times ranged from 34-44 minutes.Immediate graft function was noted in 37 kidneys; 3 patients required dialysis for delayed graft function; 4 patients had slow graft function but did not require dialysis. In a follow-up period ranging from 8 months to 5 years, no graft was lost from vascular complications following the augmentation of the RRV. All 44 venous anastomoses were safe and easy, and kinking of the renal artery was avoided because the reconstructed vein matched the length of the artery. CONCLUSION:Augmentation of the short RRV utilizing the contiguous IVC is a safe, simple, and reliable procedure that avoids graft loss from vascular complications in deceased donor renal transplantation.UroToday International Journal ® UI J

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“…Independentemente do acesso cirúrgico, a NLD para TR tem como vantagem ser potencialmente mais rápida por não ter as dissecções e ligaduras das veias adrenal, gonadal e lombares, mas, com o inconveniente, como exposto, da VRD mais curta (34,59,61,62) .…”

Section: Hospital Johns Hopkins Quanto Na Escola De Medicina Da Univeunclassified

Avaliação do comprimento das veias renais em cadáver e perda da sua extensão com três diferentes tipos de ligadura e secção

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Right renal vein elongation with the inferior vena cava for cadaveric kidney transplants: an old neglected surgical approach

Abstract: Elongation of a short right renal vein with the inferior vena cava is a feasible mean to overcome technical problems that may compromise the results of cadaveric renal transplantation.

Cited by 19 publications

References 25 publications

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Right Renal Vein Augmentation in Deceased Donor Kidney Transplantation: Importance of the Contiguous Inferior Vena Cava

Avaliação do comprimento das veias renais em cadáver e perda da sua extensão com três diferentes tipos de ligadura e secção

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