The Long-Term Outcomes of Transplantation of Kidneys With Multiple Renal Arteries

Hwang, Jeong Kye; Kim, S.D.; Park, S.C.; Choi, Bum Soon; Kim, J.I.; Yang, Chul Woo; Kim, Y.S.; Moon, In Sung

doi:10.1016/j.transproceed.2010.09.075

Cited by 35 publications

(39 citation statements)

References 7 publications

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“…It has been noticed more frequent part of stenosis in the formation of renal artery anastomosis with internal iliac artery than in the anastomosis with external iliac artery [24]. Other authors simplify this point of view indicating the effectiveness of anastomosis with internal iliac artery [25] and parity between anastomosis of renal artery with external iliac artery or internal iliac artery [26].…”

Section: Resultsmentioning

confidence: 99%

Arterial reconstructions of kidney allograft

Vildanov

Nykonenko

Русанов

et al. 2017

ZMJ

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The adequacy of blood supply in the allograft is one of the main factors of kidney transplant vitality and function and the effectiveness of transplantation itself.The aim of the study was to investigate the effectiveness and variants of arterial reconstructions of kidney allograft. Material and Methods.The results of kidney transplantation were analyzed among 66 patients. During the period from 2012 to 2016, all of them were done kidney transplantation in the department of transplantology. There were 37 (56.1 %) men, 29 women (43.9 %), the average age at the time of surgery was 33.2 ± 12.0 years. According to the aim of the study all the patients were divided into two groups: the first group included 12 (18.2 %) recipients, who received an arterial reconstruction. The age of the patients was 30.8 ± 6.5 years, there were 6 (50 %) men, other -women. Another group involved 54 (81.8 %) patients without arterial reconstruction. The average age of recipients was 33.7 ± 12.9 years, there were 31 (57.4 %) men, 23 women (42.6 %). We analyzed duplex examination of kidney allograft on the 7.6 ± 1.9 day after kidney transplantation. Results.According to the analysis of duplex examination the features of blood disorder in kidney allografts were not determined. The differences between groups were non-significant (p > 0.05). There were not identified any stenosis, thrombosis or bleeding in any cases of arterial reconstructions of kidney allograft; function of kidney allograft has preserved for the period of 2.2 ± 1.4 years. Conclusions.Adequate arterial reconstruction of kidney allograft is effective and safe method of kidney preparation for transplantation. Одним із принципових факторів життєздатності та функції пересадженої нирки, а отже й ефективності трансплантації, є адекватність кровотоку в аллотрансплантаті.Мета роботи -вивчити ефективність і варіанти артеріальних реконструкцій ниркового аллотрансплантату.Матеріали та методи. Проаналізовані результати трансплантації нирки 66 хворим. З 2012 по 2016 р. їм виконана пересадка нирки у відділенні трансплантації. Чоловіків було 37 (56,1 %), жінок -29 (43,9 %), середній вік пацієнтів -33,2 ± 12,0 року. Згідно з метою роботи пацієнтів поділили на групи: першу становили 12 (18,2 %) реципієнтів, яким виконане хірургічне втручання на артеріях трансплантату. Середній вік пацієнтів -30,8 ± 6,5 року, чоловіків було 6 (50 %), інші -жінки; друга група -54 (81,8 %) пацієнти, в яких не було необхідності в артеріальних реконструкціях аллонирки. Середній вік реципієнтів -33,7 ± 12,9 року, чоловіків було 31 (57,4 %), жінок -23 (42,6 %). Аналізували дуплексне сканування ниркового аллотрансплантату в середньому на 7,6 ± 1,9 доби після пересадки нирки.Результати. Під час дуплексного ультразвукового сканування ознак порушення кровотоку в ниркових аллотрансплантатах не виявили. Відмінності між групами статистично невірогідні (p > 0,05). У жодному випадку не зареєстровано стенозів, тромбозів або кровотеч; за період спостереження 2,2 ± 1,4 року функція аллонирок збережена.Висновки. Адекватна артер...

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Section: Resultsmentioning

confidence: 99%

Arterial reconstructions of kidney allograft

Vildanov

Nykonenko

Русанов

et al. 2017

ZMJ

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“…There are various anastomotic patterns for this situation. 1,4 Treatment of multiple arteries depends on the type of donor (living or deceased), the characteristics of multiple arteries, and the transplant surgeon's preference.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Anastomosis of 2 arteries close together on an aortic patch of a left-sided deceased-donor kidney is comparatively straightforward, whereas dual arteries in a right-sided kidney often make positioning of the kidney difficult without kinking 1 or the other artery; sometimes the arteries must be shortened to fulfill 2 separate anastomoses, and shortening the patch is contraindicated. 4 If they are > 2 to 2.5 cm apart, consideration could be given to perform 2 separate anastomoses or to shorten the patch to facilitate the anastomosis and ensure adequate and smooth perfusion of the graft.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Barlas¹,

Moris²,

Zavos³

2016

Exp Clin Transplant

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Objectives: Multiple renal arteries in donor kidneys are not a rare entity. Whenever encountered, they pose a surgical challenge in renal transplant because they require a more complicated back table vascular reconstruction and implant technique. We devel-oped a unique step-by-step in vivo illustration of the application of shortening a Carrel (aortic) patch to address multiple arteries in deceased-donor renal transplant. Materials and Methods: Case report.Results: We present the case of a 63-year-old man who received a left kidney from a deceased donor with 2 arteries on a Carrel patch that were anastomosed in a neopatch model. Conclusions: A donor kidney with multiple arteries is a challenge before arterial anastomosis. Various anastomotic patterns have been described for this situation. Treatment of multiple arteries depends mainly on the donor source (living or deceased), the characteristics of multiple arteries, and the transplant surgeon's preference. When the length of the aortic patch of a deceased donor is > 2.5 cm, the surgeon may shorten it and form a neopatch to facilitate a single arterial anastomosis to the recipient.

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“…4 An accessory superior pole renal artery <1 mm can be fastened; however, for arteries with a diameter similar to the common renal artery anastomosis should be performed. When there a 2 renal arteries both can be anastomosed to the external iliac artery end-to-side, one can be anastomosed end-to-end to the internal iliac artery and the other end-to-side to the external iliac artery, or the common renal artery can be anastomosed to the external iliac artery end-to-side and the inferior pole artery can be anastomosed to the inferior epigastric artery end-to-end.…”

Section: Arterial Anastomosismentioning

confidence: 99%

“…When the appropriate technique is used the vascular complication rate of multiple renal artery transplantation is similar to that of single renal artery transplantation. 5 In order to decrease postoperative lymphocele lymphatic channels surrounding the artery should be fastened and dissected as little as the anastomosis area. Arterial anastomosis is commonly performed in an end-to-side to the external iliac artery; however, in the right kidney, end-to-end anastomosis to the internal iliac artery can be performed.…”

Section: Arterial Anastomosismentioning

confidence: 99%