Different techniques of vessel reconstruction during kidney transplantation
Background/Aim. Multiple renal arteries (MRAs) represent a surgical challenge by the difficulty in performing anastomoses, bleeding and stenosis. MRAs should be preserved and special attention should be paid to accessory polar arteries. All renal arteries (RAs) must be reconstructed and pre...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Military Health Department, Ministry of Defance, Serbia
2015-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500038T.pdf |
| _version_ | 1818932075291475968 |
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| author | Tomić Aleksandar Milović Novak Marjanović Ivan Bjelanović Zoran Leković Ivan Micković Saša Stamenković Dušica |
| author_facet | Tomić Aleksandar Milović Novak Marjanović Ivan Bjelanović Zoran Leković Ivan Micković Saša Stamenković Dušica |
| author_sort | Tomić Aleksandar |
| collection | DOAJ |
| description | Background/Aim. Multiple renal arteries (MRAs) represent a surgical challenge
by the difficulty in performing anastomoses, bleeding and stenosis. MRAs
should be preserved and special attention should be paid to accessory polar
arteries. All renal arteries (RAs) must be reconstructed and prepared for
safe anastomosis. The paper decribed the different techniques of vessel
reconstruction during kidney transplantation including important steps within
recovery of organs, preparation and implantation. Methods. In a 16-year
period (1996-2012) of kidney transplantation in the Military Medical Academy,
Belgrade, a total of 310 living donors and 44 human cadaver kidney
transplantations were performed, of which 28 (8%) kidneys had two or more
RAs. Results. All the transplanted kidneys had immediate function. We
repaired 20 cases of donor kidneys with 2 arteries, 4 cases with three RAs,
one case with 4 RAs, one case with 4 RAs and renal vein reconstruction, one
case with 3 arteries and additional polytetrafluoroethylene (PTFE) graft
reconstruction, one case with transected renal artery and reconstruction with
5 cm long deceased donor external iliac artery. There were no major
complications and graft failure. At a minimum of 1-year follow-up, all the
patients showed normal renal function. Conclusion. Donor kidney
transplantation on a contralateral side and “end-to-end” anastomosis of the
renal artery to the internal iliac artery (IIA) is our standard procedure
with satisfactory results. Renal artery reconstruction and anastomosis with
IIA is a safe and highly efficient procedure and kidneys with MRAs are not
contraindicated for transplantation. A surgical team should be fully
competent to remove cadaveric abdominal organs to avoid accidental injuries
of organs vessels. |
| first_indexed | 2024-12-20T04:26:43Z |
| format | Article |
| id | doaj.art-29f3b19bf2e743579926110784bcfd17 |
| institution | Directory Open Access Journal |
| issn | 0042-8450 |
| language | English |
| last_indexed | 2024-12-20T04:26:43Z |
| publishDate | 2015-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-29f3b19bf2e743579926110784bcfd172022-12-21T19:53:29ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502015-01-0172761461810.2298/VSP131210038T0042-84501500038TDifferent techniques of vessel reconstruction during kidney transplantationTomić Aleksandar0Milović Novak1Marjanović Ivan2Bjelanović Zoran3Leković Ivan4Micković Saša5Stamenković Dušica6Military Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic of Urology, BelgradeMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, BelgradeMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, BelgradeMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, BelgradeMilitary Medical Academy, Clinic for Anesthesiology and Infective Care, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeBackground/Aim. Multiple renal arteries (MRAs) represent a surgical challenge by the difficulty in performing anastomoses, bleeding and stenosis. MRAs should be preserved and special attention should be paid to accessory polar arteries. All renal arteries (RAs) must be reconstructed and prepared for safe anastomosis. The paper decribed the different techniques of vessel reconstruction during kidney transplantation including important steps within recovery of organs, preparation and implantation. Methods. In a 16-year period (1996-2012) of kidney transplantation in the Military Medical Academy, Belgrade, a total of 310 living donors and 44 human cadaver kidney transplantations were performed, of which 28 (8%) kidneys had two or more RAs. Results. All the transplanted kidneys had immediate function. We repaired 20 cases of donor kidneys with 2 arteries, 4 cases with three RAs, one case with 4 RAs, one case with 4 RAs and renal vein reconstruction, one case with 3 arteries and additional polytetrafluoroethylene (PTFE) graft reconstruction, one case with transected renal artery and reconstruction with 5 cm long deceased donor external iliac artery. There were no major complications and graft failure. At a minimum of 1-year follow-up, all the patients showed normal renal function. Conclusion. Donor kidney transplantation on a contralateral side and “end-to-end” anastomosis of the renal artery to the internal iliac artery (IIA) is our standard procedure with satisfactory results. Renal artery reconstruction and anastomosis with IIA is a safe and highly efficient procedure and kidneys with MRAs are not contraindicated for transplantation. A surgical team should be fully competent to remove cadaveric abdominal organs to avoid accidental injuries of organs vessels.http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500038T.pdfkidney transplantationsurgical procedures, operativepostoperative periodrenal arteryrenal blood flow, effectiveanastomosis, surgical |
| spellingShingle | Tomić Aleksandar Milović Novak Marjanović Ivan Bjelanović Zoran Leković Ivan Micković Saša Stamenković Dušica Different techniques of vessel reconstruction during kidney transplantation Vojnosanitetski Pregled kidney transplantation surgical procedures, operative postoperative period renal artery renal blood flow, effective anastomosis, surgical |
| title | Different techniques of vessel reconstruction during kidney transplantation |
| title_full | Different techniques of vessel reconstruction during kidney transplantation |
| title_fullStr | Different techniques of vessel reconstruction during kidney transplantation |
| title_full_unstemmed | Different techniques of vessel reconstruction during kidney transplantation |
| title_short | Different techniques of vessel reconstruction during kidney transplantation |
| title_sort | different techniques of vessel reconstruction during kidney transplantation |
| topic | kidney transplantation surgical procedures, operative postoperative period renal artery renal blood flow, effective anastomosis, surgical |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500038T.pdf |
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