Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, People's Republic of China.
World J Surg. 2012 Feb;36(2):468-72. doi: 10.1007/s00268-011-1243-z.
During living-donor kidney transplantation, to maximally decrease donor injury, the right kidney with lower glomerular filtration rate often is selected as the donor kidney. However, the renal vein of the right kidney is relatively short for transplantation. The gonadal vein is essentially useless and is easily accessed during the donor nephrectomy.
Seventeen live kidney donors received right kidney nephrectomy for living-donor kidney transplantation. Short renal veins were lengthened by circular anastomosis or spiral anastomosis of longitudinally cut gonadal veins. The renal function of receivers was evaluated using creatinine clearance.
The renal veins were extended by 2.0-2.7 cm with circular anastomosis and 4.1-4.5 cm with spiral anastomosis with an average of 2.5 ± 0.7 cm. Lengthening of renal veins averaged 20.4 ± 4.2 min. All surgeries were successful, significantly reducing difficulty of vascular anastomosis during transplantation. No poor early graft function occurred. No side effects were observed in donors.
When donor renal veins are too short for effective kidney transplantation and may affect reliability of vascular anastomosis, they can be lengthened by using gonadal veins without increasing injury to the donor. Successful extension of donor kidney renal veins expands the indication for right donor kidneys.
在活体供肾移植中，为了最大限度地减少供者损伤，通常选择肾小球滤过率较低的右肾作为供肾。然而，右肾的肾静脉相对较短，用于移植。生殖静脉在本质上是无用的，并且在供肾切除术期间很容易触及。
17 名活体供肾者接受右肾切除术进行活体供肾移植。通过对纵向切割的生殖静脉进行圆形吻合或螺旋吻合来延长短肾静脉。通过肌酐清除率评估受体的肾功能。
通过圆形吻合延长肾静脉 2.0-2.7cm，通过螺旋吻合延长 4.1-4.5cm，平均延长 2.5±0.7cm。延长肾静脉的平均时间为 20.4±4.2 分钟。所有手术均成功，显著降低了移植过程中血管吻合的难度。无一例早期移植物功能不良。供者无不良反应。
当供肾静脉太短而无法有效进行肾移植且可能影响血管吻合的可靠性时，可以使用生殖静脉延长供肾静脉，而不会增加供者的损伤。成功延长供体肾脏静脉，扩大了右供体肾脏的适应证。
