Wang Li, He Fan, Shi Ming, Lu Yiping, Yang Yuru
Department of Urology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 May;22(5):582-5.
To discuss renovascular reconstruction during living related donor kidney transplantation (LDKT).
Seventy-seven cases of LDKT from April 2006 to March 2008 were retrospectively analyzed, including 63 cases in single renal artery group and 14 cases in multiple artery group. In multiple artery group, there were 3 cases of three arteries and 11 cases of double arteries; 9 cases of donated left kidneys and 5 cases of donated right kidneys. Potential donors underwent fully medical evaluation before operation, including donor-recipient human leucocyte antigen matching and a cross match test. The donor's operation of the incision either underneath the 12th rib approaching the dorsal lumbar was performed and the transplantation operation adopted the extraperitoneal approach in the contralateral fossa iliac. The arteries in the multiple artery group were implanted onto the external (or common) iliac artery different from the orthodox method.
In multiple artery group, no blood transfusion during operation was performed, no complication occurred after operation and all donors were discharged after 7-9 days of postoperation. After a follow-up of 3 months to 1 year, all the recipients kept normal kidney function without renal tubule necrosis, renal artery embolism, vascular stenosis, urinary fistula and ureter necrosis. The ultrasound examination showed that the transplanted kidney had good blood supply. There was no significant difference in the time of urine secretion, serum creatinine level after 1 week of operation, length of hospitalization between the multiple artery group and the single artery group (P > 0.05).
The accurate treatment of multiple artery anastomosis are critical for the safety of the LDKT.
探讨亲属活体肾移植（LDKT）术中肾血管重建方法。
回顾性分析2006年4月至2008年3月行LDKT的77例患者，其中单肾动脉组63例，多动脉组14例。多动脉组中，3支动脉3例，2支动脉11例；供左肾9例，供右肾5例。供者术前均进行全面医学评估，包括供受者人类白细胞抗原配型及交叉配血试验。供者采用第12肋下背侧入路手术，移植手术采用对侧髂窝腹膜外入路。多动脉组肾动脉采用不同于传统方法吻合于髂外（或总）动脉。
多动脉组术中无输血，术后无并发症发生，供者术后7～9天均出院。随访3个月至1年，所有受者肾功能均正常，无肾小管坏死、肾动脉栓塞、血管狭窄、尿瘘及输尿管坏死。超声检查显示移植肾血供良好。多动脉组与单动脉组在术后尿分泌时间、术后1周血清肌酐水平、住院时间方面比较，差异无统计学意义（P＞0.05）。
准确处理多动脉吻合对亲属活体肾移植的安全性至关重要。
