Implantation of Right Kidneys: Is the Risk of Technical Graft Loss Real?

Khan, Taqi; Ahmad, Nadeem; Siddique, Kashif; Fourtounas, Konstantinos

doi:10.1007/s00268-017-4314-y

Cited by 3 publications

(15 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 of the 15 LD studies 29,36,37,45,47,52 reporting rates of graft thrombosis did not observe any incidents of thrombosis. The 9 LD [5][6][7][8][9][10][11]41,43 and 3 DD 15,17,18…”

Section: Graft Thrombosismentioning

confidence: 86%

“…Anastomosis time for living and deceased donors was significantly longer for right versus left kidneys. Meta-analysis of the 4 LD studies 7,47,52,53…”

Section: Impact On Ischaemic Timementioning

confidence: 99%

“…Of the 20 LD studies which reported renal function, 18 found no significant difference in renal function between sides. [6][7][8][9]33,[35][36][37][38]40,42,44,[46][47][48][49][50]52 Omoto et al 45 found significant difference in day one post-transplant creatinine (4.5 ± 2.4 mg/dL versus 3.7 ± 1.9 in right versus left kidneys; P = .038) but after this no difference between sides. Özdemir-van Brunschot et al 53 DD studies that recorded renal function found there to be a significant difference between right and left kidneys at any timepoint.…”

Section: Renal Functionmentioning

confidence: 99%

See 2 more Smart Citations

Comparing outcomes in right versus left kidney transplantation: A systematic review and meta‐analysis

Carolan

Tingle

Thompson

et al. 2021

Clinical Transplantation

View full text Add to dashboard Cite

Introduction: Transplantation of right kidneys can pose technical challenges due to the short right renal vein. Whether this results in inferior outcomes remains controversial.Method: Healthcare Database Advanced Search (HDAS) was used to identify relevant studies. Two authors independently reviewed each study. Statistical analyses were performed using random effects models and results expressed as HR or relative risk (RR) with 95% confidence intervals. Subgroup analyses were performed in kidneys from deceased donors (DD) and living donors (LD).Results: A total of 35 studies (257,429 participants) were identified. Both deceased and living donor right kidneys were at increased risk of delayed graft function (DGF; RR = 1.12[1.06-1.18] and RR = 1.33[1.21-1.46] respectively; both p < .0001). In absolute terms, for each 100 kidney pairs of DD kidneys transplanted there are 2.72 (1.67-3.78, p < .00001) excess episodes of DGF in right kidneys. Graft thromboses and graft loss due to technical failure was also significantly more likely in right kidneys, in both DD and LD settings. There was no evidence that laterality alters long term graft survival in LD or DD. Conclusion:Right kidneys have inferior early outcomes, with higher rates of DGF, technical failure and graft thrombosis. However, these differences are small in absolute terms, and long-term graft survival is equivalent.

show abstract

“…6 of the 15 LD studies 29,36,37,45,47,52 reporting rates of graft thrombosis did not observe any incidents of thrombosis. The 9 LD [5][6][7][8][9][10][11]41,43 and 3 DD 15,17,18…”

Section: Graft Thrombosismentioning

confidence: 86%

“…Anastomosis time for living and deceased donors was significantly longer for right versus left kidneys. Meta-analysis of the 4 LD studies 7,47,52,53…”

Section: Impact On Ischaemic Timementioning

confidence: 99%

Section: Renal Functionmentioning

confidence: 99%

See 1 more Smart Citation

Comparing outcomes in right versus left kidney transplantation: A systematic review and meta‐analysis

Carolan

Tingle

Thompson

et al. 2021

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Transplant surgeons prefer left-sided living donor kidneys because the longer renal vein facilitates implantation of the donor kidney to the deeply situated recipient right iliac vein ( 1 – 8 ). Compared with the use of right living donor kidneys, both the tension on the venous anastomosis and the potential kinking of a longer right renal artery are minimized when using left kidneys ( 4 – 6 , 9 ). International registry and cohort studies demonstrate that more left kidneys are transplanted than right, particularly following the introduction of laparoscopic nephrectomy ( 1 , 7 , 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between Side of Living Kidney Donation and Post-Transplant Outcomes

Dobrijevic¹,

Au²,

Rogers³

et al. 2022

Transpl Int

View full text Add to dashboard Cite

Background: Right-sided living donor kidneys have longer renal arteries and shorter veins that make vascular anastomosis more challenging. We sought to determine whether recipients of right-sided living donor kidneys have worse outcomes than left-sided kidney recipients.Methods: An observational analysis of the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) was undertaken. We used adjusted logistic regression to determine the association between side and delayed graft function (DGF) and time-stratified adjusted cox regression models for graft and patient survivals.Results: Between 2004 and 2018, 4,050 living donor kidney transplants were conducted with 696 (17.2%) using right kidneys. With reference to left kidneys, the adjusted OR (95% CI) for DGF was 2.01 (1.31–3.09) for recipients with right kidneys. Within 30 days, 46 allografts (1.4%) were lost, with major causes of overall graft loss being technical, primary non-function and death. Recipients of right donor kidneys experienced a greater risk of early graft loss (aHR 2.02 [95% CI 1.06–3.86], p = 0.03), but not beyond 30 days (aHR 0.97 [95% CI 0.80–1.19], p = 0.8]).Conclusion: Technical challenge is the most common cause of early graft loss. The risk of early graft loss among recipients who received right kidneys is doubled compared to those who received left living donor kidneys.

show abstract

“…To facilitate the reconstruction, a 3-4 mm cuff of IVC should be left while separating the LRV at time of procurement [7]. Despite evidence correlating use of right kidneys and vascular thrombosis [8], other series could not identify laterality as a risk factor [9,10]. A retrospective cohort study from the Netherlands analyzed 4,372 living and 5,346 deceased donor kidney transplants and found the use of right kidneys increased the incidence of technical graft failure only when using living donors (multivariate analysis p=0.03) [11].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2019

IJTPS

View full text Add to dashboard Cite

Transplantation of the right kidney from cadaveric donors is more technically challenging than transplantation of the left kidney due to the shorter length of the right renal vein. Several techniques have been used to extend the right renal vein, but the paucity of data to guide evidence-based decisions mandates that the surgeon must approach each transplant on a case-by-case basis. It is generally agreed that extension of the right renal vein allows for an easier implantation. This paper provides a brief review of several techniques for right renal vein extension in deceased donors.

show abstract

Implantation of Right Kidneys: Is the Risk of Technical Graft Loss Real?

Abstract: Based on our data, the use of RKs was not a risk factor for technical graft loss and early graft function was comparable to LKs.

Cited by 3 publications

References 29 publications

Comparing outcomes in right versus left kidney transplantation: A systematic review and meta‐analysis

Comparing outcomes in right versus left kidney transplantation: A systematic review and meta‐analysis

Association Between Side of Living Kidney Donation and Post-Transplant Outcomes

Untitled

Contact Info

Product

Resources

About