Khanam A, Alam M R, Ahmed A H, Khan S A
Department of Nephrology, Bangabandhu Sheik Mujib Medical University, Shahbagh, Dhaka, Bangladesh.
Mymensingh Med J. 2011 Jan;20(1):88-92.
The use of grafts with multiple renal arteries has been considered a relative contraindication because of the increased incidence of vascular and urologic complications. The aim of this retrospective study is to determine whether the kidney grafts with multiple arteries have any adverse effect upon post transplant graft and patient survival. After reviewing the records of 35 adult kidney transplants done consecutively at Bangabandhu Sheik Mujib Medical University over a period of 3 years (Jan 2005 to Dec 2007). Mean age of recipients. 43.46±12.11 years and donors 40.33±11.46 years. Twenty patients (Group A) had grafts with single renal artery and 15 patients (Group B) had grafts with multiple renal arteries. The incidence of vascular complications, ureteral complications, post surgical haemorrhage, mean serum creatinine level and acute tubular necrosis in both Group A & B were observed. Complications developed in 15(43%) patients in this series. In Group A, 1(5%) developed post operative bleeding cause perinephric hematoma, 1(5%) technical obstruction of ureter, 1(5%) sloughed ureter, graft nephrectomy 1(5%) and acute tubular necrosis 1(5%) patient. In Group B, 2(13%) patients developed hematoma, urine leak 3(20%), sloughed ureter 1(6%), graft nephrectomy 1(6%) and acute tubular necrosis 3(20%) patients. Though the kidney grafts with multiple renal arteries have been considered a relative contraindication because of the increased risk of complication. In this series incidence of complication was 43%. The higher rate probably reflects the small number of living related donors.
由于血管和泌尿系统并发症的发生率增加,使用具有多条肾动脉的移植物被视为相对禁忌证。这项回顾性研究的目的是确定具有多条动脉的肾移植物是否对移植后移植物和患者存活有任何不良影响。在回顾了达卡班加班杜·谢赫·穆吉布医科大学在3年期间(2005年1月至2007年12月)连续进行的35例成人肾移植记录后发现,受者的平均年龄为43.46±12.11岁,供者的平均年龄为40.33±11.46岁。20例患者(A组)的移植物有单一肾动脉,15例患者(B组)的移植物有多个肾动脉。观察了A组和B组的血管并发症、输尿管并发症、术后出血、平均血清肌酐水平和急性肾小管坏死的发生率。本系列中有15例(43%)患者出现并发症。在A组中,1例(5%)发生术后出血导致肾周血肿,1例(5%)输尿管技术梗阻,1例(5%)输尿管脱落,1例(5%)进行了移植肾切除术,1例(5%)发生急性肾小管坏死。在B组中,2例(13%)患者出现血肿,3例(20%)出现尿漏,1例(6%)输尿管脱落,1例(6%)进行了移植肾切除术,3例(20%)发生急性肾小管坏死。尽管由于并发症风险增加,具有多条肾动脉的肾移植物被视为相对禁忌证,但在本系列中并发症发生率为43%。较高的发生率可能反映了活体亲属供者数量较少。