En-Bloc Transplantation of Dual Adult Kidneys with Multiple Vessels
<b>Background</b>. To provide optimal nephron mass, two adult kidneys with suboptimal function can be transplanted into one single recipient. All techniques described to date are based on the lengthy sequential transplantation of one allograft after the other, in each iliac fossa, or thr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Uro |
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| Online Access: | https://www.mdpi.com/2673-4397/1/4/30 |
| _version_ | 1797500108980355072 |
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| author | Dai D. Nghiem |
| author_facet | Dai D. Nghiem |
| author_sort | Dai D. Nghiem |
| collection | DOAJ |
| description | <b>Background</b>. To provide optimal nephron mass, two adult kidneys with suboptimal function can be transplanted into one single recipient. All techniques described to date are based on the lengthy sequential transplantation of one allograft after the other, in each iliac fossa, or through one long incision in the right iliac quadrant. <b>Material and Methods</b>. We report on a novel shorter and simpler operative technique allowing the en-bloc transplantation of seven dual adult kidneys with multiple vessels into a single iliac fossa, with revascularization through the donor aorta and vena cava. A proposal for the identification, allocation, procurement, and placement of the dual adult kidneys is presented. <b>Results</b>. There was no primary non-function, no thrombosis, and no urinary leakage. No urosepsis and hydronephrosis were noted during the follow-up. The operative time was 180 min. At 36 months, serum creatinine levels averaged 1.8 mg/dL (range 1.4–1.9 mg/dL). <b>Conclusions</b>. The procedure described permits converting two complex vascular kidneys into one en-bloc graft, which then can be transplanted into a single iliac incision, using only one arterial and one venous anastomoses. It avoids extensive dissection, shortens the operative time, and reduces the complications rate for the elderly recipients. It is applicable to the transplantation of dual kidneys with single or multiple arteries. |
| first_indexed | 2024-03-10T03:57:10Z |
| format | Article |
| id | doaj.art-83b69913b5854044a7cd6539763aadab |
| institution | Directory Open Access Journal |
| issn | 2673-4397 |
| language | English |
| last_indexed | 2024-03-10T03:57:10Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Uro |
| spelling | doaj.art-83b69913b5854044a7cd6539763aadab2023-11-23T10:53:26ZengMDPI AGUro2673-43972021-12-011427428010.3390/uro1040030En-Bloc Transplantation of Dual Adult Kidneys with Multiple VesselsDai D. Nghiem0Department of Surgery, Division of Transplantation, Allegheny Health Network, Pittsburgh, PA 15212, USA<b>Background</b>. To provide optimal nephron mass, two adult kidneys with suboptimal function can be transplanted into one single recipient. All techniques described to date are based on the lengthy sequential transplantation of one allograft after the other, in each iliac fossa, or through one long incision in the right iliac quadrant. <b>Material and Methods</b>. We report on a novel shorter and simpler operative technique allowing the en-bloc transplantation of seven dual adult kidneys with multiple vessels into a single iliac fossa, with revascularization through the donor aorta and vena cava. A proposal for the identification, allocation, procurement, and placement of the dual adult kidneys is presented. <b>Results</b>. There was no primary non-function, no thrombosis, and no urinary leakage. No urosepsis and hydronephrosis were noted during the follow-up. The operative time was 180 min. At 36 months, serum creatinine levels averaged 1.8 mg/dL (range 1.4–1.9 mg/dL). <b>Conclusions</b>. The procedure described permits converting two complex vascular kidneys into one en-bloc graft, which then can be transplanted into a single iliac incision, using only one arterial and one venous anastomoses. It avoids extensive dissection, shortens the operative time, and reduces the complications rate for the elderly recipients. It is applicable to the transplantation of dual kidneys with single or multiple arteries.https://www.mdpi.com/2673-4397/1/4/30en-bloc transplantationmultiple arteriessimultaneous dual adult kidneysdonor aorta and vena cavaen-bloc donor nephrectomiesdual adult kidney allocation |
| spellingShingle | Dai D. Nghiem En-Bloc Transplantation of Dual Adult Kidneys with Multiple Vessels Uro en-bloc transplantation multiple arteries simultaneous dual adult kidneys donor aorta and vena cava en-bloc donor nephrectomies dual adult kidney allocation |
| title | En-Bloc Transplantation of Dual Adult Kidneys with Multiple Vessels |
| title_full | En-Bloc Transplantation of Dual Adult Kidneys with Multiple Vessels |
| title_fullStr | En-Bloc Transplantation of Dual Adult Kidneys with Multiple Vessels |
| title_full_unstemmed | En-Bloc Transplantation of Dual Adult Kidneys with Multiple Vessels |
| title_short | En-Bloc Transplantation of Dual Adult Kidneys with Multiple Vessels |
| title_sort | en bloc transplantation of dual adult kidneys with multiple vessels |
| topic | en-bloc transplantation multiple arteries simultaneous dual adult kidneys donor aorta and vena cava en-bloc donor nephrectomies dual adult kidney allocation |
| url | https://www.mdpi.com/2673-4397/1/4/30 |
| work_keys_str_mv | AT daidnghiem enbloctransplantationofdualadultkidneyswithmultiplevessels |