A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centre
Background: Chronic kidney disease (CKD) is a major epidemic in India today. Renal transplant offers the best quality of life; however, only about 6000 mostly live donor transplants are performed due to socioeconomic hurdles. Live donor transplants involve tenuous (2–6 mm) graft arteries without a c...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Indian Journal of Transplantation |
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| Online Access: | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2020;volume=14;issue=2;spage=125;epage=129;aulast=Rana |
| _version_ | 1818311293909598208 |
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| author | Anil Kumar Singh Rana Nitin Agarwal Vinay M Hanumanthappa Manoj Kumar Dokania |
| author_facet | Anil Kumar Singh Rana Nitin Agarwal Vinay M Hanumanthappa Manoj Kumar Dokania |
| author_sort | Anil Kumar Singh Rana |
| collection | DOAJ |
| description | Background: Chronic kidney disease (CKD) is a major epidemic in India today. Renal transplant offers the best quality of life; however, only about 6000 mostly live donor transplants are performed due to socioeconomic hurdles. Live donor transplants involve tenuous (2–6 mm) graft arteries without a cuff; thus meticulous technique is importance. We have prospectively compared graft anastomosis to the external iliac artery end-to-side (EIA ES) with the internal iliac end-to-end (IIA EE) artery. Materials and Methods: This prospective randomized study was conducted in the renal transplant unit of a teaching hospital in north India for over 2 years. After ethics approval and informed consent, patients with donors were randomly divided into two groups using computer-generated tables and the sealed envelope technique; Group 1 underwent EIA ES; Group 2 underwent IIA EE. Donor nephrectomy was by a supra 11th rib flank incision, and triple immunosuppression was used. The vascular techniques were standardized; outcome parameters were the duration of anastomosis and complications, especially delayed graft function. Follow-up was for 3 months. Results: The mean age was 36.85 ± 13.56 and 29.75 ± 8.06 years while female: male ratio of recipients was 3:17 and 6:14 in Groups 1 and 2, respectively. The groups were comparable in venous anastomosis duration, warm ischemia interval, cold ischemia interval and hospital stay, and other complications, but significantly longer arterial anastomosis time was noted in the IIA EE group (P = 0.001). Conclusions: EIA ES took less time than IIA EE, but was equivalent to in most parameters. More data are needed to answer this debate. |
| first_indexed | 2024-12-13T07:59:40Z |
| format | Article |
| id | doaj.art-20533f59f7154d2ba5a08aeed2419cc3 |
| institution | Directory Open Access Journal |
| issn | 2212-0017 2212-0025 |
| language | English |
| last_indexed | 2024-12-13T07:59:40Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Transplantation |
| spelling | doaj.art-20533f59f7154d2ba5a08aeed2419cc32022-12-21T23:54:28ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252020-01-0114212512910.4103/ijot.ijot_16_20A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centreAnil Kumar Singh RanaNitin AgarwalVinay M HanumanthappaManoj Kumar DokaniaBackground: Chronic kidney disease (CKD) is a major epidemic in India today. Renal transplant offers the best quality of life; however, only about 6000 mostly live donor transplants are performed due to socioeconomic hurdles. Live donor transplants involve tenuous (2–6 mm) graft arteries without a cuff; thus meticulous technique is importance. We have prospectively compared graft anastomosis to the external iliac artery end-to-side (EIA ES) with the internal iliac end-to-end (IIA EE) artery. Materials and Methods: This prospective randomized study was conducted in the renal transplant unit of a teaching hospital in north India for over 2 years. After ethics approval and informed consent, patients with donors were randomly divided into two groups using computer-generated tables and the sealed envelope technique; Group 1 underwent EIA ES; Group 2 underwent IIA EE. Donor nephrectomy was by a supra 11th rib flank incision, and triple immunosuppression was used. The vascular techniques were standardized; outcome parameters were the duration of anastomosis and complications, especially delayed graft function. Follow-up was for 3 months. Results: The mean age was 36.85 ± 13.56 and 29.75 ± 8.06 years while female: male ratio of recipients was 3:17 and 6:14 in Groups 1 and 2, respectively. The groups were comparable in venous anastomosis duration, warm ischemia interval, cold ischemia interval and hospital stay, and other complications, but significantly longer arterial anastomosis time was noted in the IIA EE group (P = 0.001). Conclusions: EIA ES took less time than IIA EE, but was equivalent to in most parameters. More data are needed to answer this debate.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2020;volume=14;issue=2;spage=125;epage=129;aulast=Ranaend-to-side anastomosisexternal iliac arteryindialive relatedrenal transplant |
| spellingShingle | Anil Kumar Singh Rana Nitin Agarwal Vinay M Hanumanthappa Manoj Kumar Dokania A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centre Indian Journal of Transplantation end-to-side anastomosis external iliac artery india live related renal transplant |
| title | A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centre |
| title_full | A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centre |
| title_fullStr | A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centre |
| title_full_unstemmed | A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centre |
| title_short | A prospective comparison of end-to-side and end-to-end renal transplant arterial anastomosis in living donor transplants from an Indian centre |
| title_sort | prospective comparison of end to side and end to end renal transplant arterial anastomosis in living donor transplants from an indian centre |
| topic | end-to-side anastomosis external iliac artery india live related renal transplant |
| url | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2020;volume=14;issue=2;spage=125;epage=129;aulast=Rana |
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