Clinical Evaluation of Donor Renal Artery Reconstruction in Kidney Transplantation

Miura, Masayoshi; Seki, Toshimori; Harada, Hiroshi; Tanda, Katsutoshi; Chikaraishi, Tatsuya; Nonomura, Katsuya; Koyanagi, Tomohiko; Terabe, Masaki

doi:10.5980/jpnjurol1989.88.566

Cited by 3 publications

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“…Troppmann et al 17 reported that small, usually upper polar accessory renal arteries could be ligated if they supplied less than 5%-10% of the renal parenchyma. Miura et al 18 described that renal arterial reconstruction is indicated except for arteries with diameters of less than 1 mm and those that supply the upper pole of the kidney. Ganesan et al 19 reported that an upper polar artery could be safely ligated if the surface area supplied by the clamped polar artery is smaller than 1 cm 2 , whereas a lower polar artery should never be ligated because it supplies the ureter.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive method using multidetector CT for calculating the relative blood supply ratio of duplicated renal arteries in renal donors

Kuwabara

Narumi

Takahashi³

et al. 2006

Radiat Med

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Section: Discussionmentioning

confidence: 99%

Noninvasive method using multidetector CT for calculating the relative blood supply ratio of duplicated renal arteries in renal donors

Kuwabara

Narumi

Takahashi³

et al. 2006

Radiat Med

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“…Hence, these techniques have extended the available treatments for these diseases. Ex vivo repair has also allowed the repair of traumatically damaged donor kidneys, thus increasing the transplant rate 24 . Hence, the benefits of ex vivo surgery and autotransplantation may not be applied only to difficult clinical problems, but also to the field of allotransplantation.…”

Section: Discussionmentioning

confidence: 99%

Successful ex vivo renal artery reconstruction and renal autotransplantation

Cho¹,

Robinson²,

Grant³

et al. 2001

ANZ Journal of Surgery

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Background: The increasing experience with renal allotransplantation has led to continuing development in vascular surgical techniques. These improvements have enabled complex ex vivo renal artery surgery and renal autotransplantation to be performed. The aims of the present study were to describe the results achieved with renal autotransplantation and ex vivo renal artery reconstruction (RAR) at the Newcastle Transplant Unit, John Hunter Hospital, and to review the current indications for such surgery. Methods: A retrospective review was performed of patients who required renal autotransplantation with or without RAR at John Hunter Hospital, between 1991 and 1999. Data were obtained from the Newcastle Transplant Unit and the Medical Record Department of John Hunter Hospital. Results: Two patients required ex vivo RAR and renal autotransplantation for severe fibromuscular dysplasia (FMD) complicated by stenoses and renal artery branch aneurysms. The third patient required autotransplantation for bilateral retroperitoneal fibrosis. There was one postoperative complication of pelviureteric junction obstruction that was treated successfully with a temporary ureteric stent. All patients demonstrated normal graft function and were normotensive on follow up, which ranged from 2.5 to 5 years. Conclusion: The present review confirms the long‐term benefits of ex vivo RAR and renal autotransplantation that have been demonstrated by previous studies. In transplant units experienced with this surgery it has been shown to be a successful and durable technique for the treatment of a variety of vascular, urologic and other diseases.

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“…Several surgical and microsurgical techniques of intracorporeal and ex vivo surgeries have been used to implant kidneys with multiple arteries. 5,7,9 The advantages, disadvantages and the outcome of ex vivo and intracorporeal anastomotic techniques are not clearly defi ned up to this moment.1 In situ techniques include the use of various branches of the recipient hypogastric artery, a combination of hypogastric and external iliac arteries, multiple individual endto-side anastomoses to the external iliac artery, and even the inferior epigastric artery 7,10 . On the other hand, the main objective of the ex vivo microvascular techniques 11 is to create a single arterial ostium to facilitate the in situ vascular anastomosis with maximal accuracy and minimal warm ischemic damage to the kidney.…”

Section: Commentsmentioning

confidence: 99%

Hand-assisted laparoscopic nephrectomy in a donor with triple renal vessels

Branco¹,

Kondo²,

Bignelli³

2005

bjt

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Objective: Donor availability is an important limiting factor in renal transplant programs; consequently, it is important to be able to use every vital organ independent of the vascular anatomy. Method: It is reported a successful case-story of hand-assisted laparoscopic nephrectomy in a 69-year-old related donor with triple renal vessels. The estimated blood loss was of 100 mL, the operative time was of 80 minutes and the warm ischemia time was of 3.0 minutes. The transplant was performed in the left iliac fossa. The donor experienced an excellent recovery, and she was discharged in the second postoperative day. The recipient was discharged home in the8th postoperative day, and her creatinine level was of 1.3mg%. Discussion and Conclusion: It was demonstrated the feasibility of hand-assisted laparoscopic nephrectomy in a patient with triple renal vessels, and we also share the opinion that in experienced hands, all procedures can be done by laparoscopy with no additional risk to the donor and/or the recipient.

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Clinical Evaluation of Donor Renal Artery Reconstruction in Kidney Transplantation

Cited by 3 publications

References 0 publications

Noninvasive method using multidetector CT for calculating the relative blood supply ratio of duplicated renal arteries in renal donors

Noninvasive method using multidetector CT for calculating the relative blood supply ratio of duplicated renal arteries in renal donors

Successful ex vivo renal artery reconstruction and renal autotransplantation

Hand-assisted laparoscopic nephrectomy in a donor with triple renal vessels

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