Donor vascular patch for reconstruction of the aorta and inferior vena cava in pediatric en bloc kidney transplantation

Garcia, Lydia; González, Juan Abreu; Serena, Giuseppe; Al-Nuss, M. Ammar; Morsi, Mahmood; DeFaria, Werviston; Ciancio, Gaetano

doi:10.1016/j.acuroe.2019.05.007

Cited by 2 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although there are few reports of back-table EBPK reconstruction and transplantation with good graft function previously published [ 7 , 25 – 27 ], all these reports agree on the crucial role of using a meticulous technique during the vascular reconstruction [ 7 , 25 – 27 ], which, in the light of the results obtained in this case, we also recognize as essential.…”

Section: Discussionsupporting

confidence: 75%

“…Therefore, aiming to avoid vascular complications secondary to excessive traction at the anastomotic sites, in our patient, cap-shaped same-donor grafts were placed in both proximal ends of the allograft aorta and IVC [ 23 ], and 2 conduits were placed at the distal allograft vascular ends, thus permitting their elongation. The reconstruction using vascular elongation patches and conduits has proved to be a useful and safe method for decreasing the incidence of vascular-related complications in transplantation [ 7 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since a direct closure of both proximal vascular ends would compromise adequate graft hemodynamics, same-donor cap-shaped patches were used to close each of the proximal ends with 7-0 Prolene ® running sutures [ 7 ]. At this point, the allograft was connected to the LifePort ® renal preservation machine and stored in hypothermia (2–4ºC) using kidney perfusion solution (KPS-1 ® ) ( Figure 1 ).…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Transplantation of 2-Month-Old En Bloc Pediatric Kidneys After a Complex Vascular Reconstruction – Traveling 2500 Miles to Get Transplanted: A Case Report

et al. 2021

View full text Add to dashboard Cite

Patient: Male, 30-year-old Final Diagnosis: End stage renal disease secondary to hypertensive nephropathy Symptoms: Uremic symptoms Medication:— Clinical Procedure: — Specialty: Transplantology Objective: Rare disease Background: En bloc pediatric kidneys (EBPK) are one potential solution to increase the number of organs available in the donor community, thus promoting transplantation of these allografts into adult recipients. However, EBPK transplantation has been traditionally considered suboptimal due to concerns for perioperative complications, mainly vascular thrombosis. We report an en bloc kidney transplantation using vascular grafts from another deceased donor to extend the EBPK aorta and vena cava and create a tension-free anastomosis with recipient external iliac vessels. Case Report: A pair of 2-month-old female en bloc kidneys weighting 6 kg were transplanted to a 30-year-old adult male. Prolonged cold ischemic time (CIT) was related to high refusal rate and long travel from Nevada to Miami. Prior to transplantation, the EBPK were connected to the LifePort Renal Preservation Machine ® and deemed transplantable only after showing a significant improvement in perfusion parameters. Back-table reconstruction was conducted through an end-to-end anastomosis between an adult deceased donor common iliac artery and vein grafts to the inferior vena cava and aortic distal ends, respectively. The patient displayed immediate graft function (IGF) without any postoperative complications, showing a creatinine of 1.5 mg/dl at 4-month follow-up. Conclusions: Use of renal preservation machine (RPM) and refined back-table reconstruction of these allografts are important tools to improve the significant discard rate and improve outcomes of EBPK.

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Transplantation of 2-Month-Old En Bloc Pediatric Kidneys After a Complex Vascular Reconstruction – Traveling 2500 Miles to Get Transplanted: A Case Report

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In order to reduce the risk of these vascular complications, we describe the use of cap-shaped patches from the same donor as a conduit in both proximal ends of the allograft aorta and IVC and at the distal allograft vascular end, providing increased length to reduce excessive traction and subsequent thrombosis and/or stenosis [ 16 , 17 ]. The use of elongation patches and conduits proves to be a useful and safe method for decreasing the incidence of vascular-related complications in transplantation [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Complex Vascular Reconstruction of an En Bloc Pediatric Kidney Damaged during Organ Procurement

Riella

Tabbara

Abreu

et al. 2022

Case Reports in Transplantation

View full text Add to dashboard Cite

En bloc pediatric kidney (EBPK) allografts are a potential solution to expand the organ donor pool; however, EBPK transplantation has been traditionally considered suboptimal due to concerns of perioperative vascular and urologic complications. Accidental organ or vasculature injury during harvest is not uncommon; however, this does not necessarily mean that the organ should be discarded. Careful vascular reconstruction can be performed using donor vascular grafts, salvaging the organ without stenosis or thrombosis of the vessels. We report an extensive vascular reconstruction of the right renal artery, aorta, and inferior vena cava of a damaged EBPK allograft using a donor pediatric aorta vascular patch with the goal of avoiding postoperative vascular complications.

show abstract

Donor vascular patch for reconstruction of the aorta and inferior vena cava in pediatric en bloc kidney transplantation

Cited by 2 publications

References 6 publications

Transplantation of 2-Month-Old En Bloc Pediatric Kidneys After a Complex Vascular Reconstruction – Traveling 2500 Miles to Get Transplanted: A Case Report

Transplantation of 2-Month-Old En Bloc Pediatric Kidneys After a Complex Vascular Reconstruction – Traveling 2500 Miles to Get Transplanted: A Case Report

Complex Vascular Reconstruction of an En Bloc Pediatric Kidney Damaged during Organ Procurement

Contact Info

Product

Resources

About