Oh Henry K, Hawasli Abdelkader, Cousins Geoffrey
Department of Surgery, Division of Transplant Surgery, St John Hospital and Medical Center, Detroit, MI 48236-2172, USA.
Clin Transplant. 2003 Aug;17(4):353-7. doi: 10.1034/j.1399-0012.2003.00058.x.
Laparoscopic living donor nephrectomy (LLDN) has become an accepted procedure in many transplant centers. The placement of laparoscopic vascular staples can result in multiple short, small-caliber renal arteries that the recipient surgeon must deal with to restore perfusion to all parts of the kidney. The incidence of multiple renal arteries resulting from LLDN, surgical management of multiple renal arteries, and the short- and long-term graft functions were studied in 73 consecutive kidney recipients at a single center. Various techniques used for reconstruction are described, including the use of recipient internal iliac artery for the extension and reconstruction of small-caliber, short renal vessels. Single-artery allografts were compared with those with multiple arteries, with length of renal artery, warm ischemia time, hospital length of stay, operating time, creatinine levels, and 1 yr survival rates not found to be significantly different. The presence of multiple renal arteries should not exclude the possibility of using the left kidney for LLDN.
腹腔镜活体供肾肾切除术（LLDN）在许多移植中心已成为一种被认可的手术方式。腹腔镜血管吻合器的使用可能导致多条短而小口径的肾动脉，受体外科医生必须处理这些动脉以恢复肾脏各部分的灌注。在一个单一中心，对73例连续的肾移植受体进行了研究，探讨了LLDN导致多支肾动脉的发生率、多支肾动脉的手术处理方法以及短期和长期移植肾功能。文中描述了用于重建的各种技术，包括使用受体髂内动脉来延长和重建小口径、短的肾血管。将单动脉同种异体肾移植与多动脉同种异体肾移植进行比较，发现肾动脉长度、热缺血时间、住院时间、手术时间、肌酐水平和1年生存率并无显著差异。存在多支肾动脉不应排除使用左肾进行LLDN的可能性。
