Uysal Erdal, Yuzbasioglu M Fatih, Ikidag Mehmet A, Dokur Mehmet, Gurer O Ahmet
From the Department of General Surgery and Transplantation Center, Sanko University School of Medicine, Gaziantep, Turkey.
Exp Clin Transplant. 2017 Aug;15(4):467-469. doi: 10.6002/ect.2015.0002. Epub 2016 Jan 20.
The objective of this presentation is to share our experiences with a successful reconstruction of a short graft renal artery using a gonadal vein, which occurred during a difficult laparoscopic donor nephrectomy.
A 27-year-old man was referred to our clinic for a living-related renal transplant with a diagnosis of end-stage renal disease. The donor was with his mother. At last, a laparoscopic donor nephrectomy was planned. Massive intra-abdominal hemorrhage occurred during the dissection of renal artery. Urgent intervention was performed to maintain the patency of renal allograft and to stabilize the donor. Hemorrhage was brought under control. Donor nephrectomy was completed with a short remaining segment of renal artery. We decided to use the elongation of the graft renal artery using the gonadal vein of the same side was decided. End-to-end anastomosis was performed. After elongation of graft renal artery, anastomosis to internal iliac artery was performed. The trans-plant procedure was completed successfully. The kidney functioned immediately. Doppler ultrasound revealed that perfusion of the kidney was normal. The postoperative creatinine levels of recipient were in the normal ranges. Daily urine output was normal. There are not enough publications about elongation of graft renal artery using gonadal vein.
Elongation of a short remaining graft renal artery by using gonadal vein seems to be a simple, safe, and reliable method. This technique provides an alternative approach for the reconstruction of short renal arteries in living-donor kidney transplants.
本报告的目的是分享我们在困难的腹腔镜供肾切除术期间，使用性腺静脉成功重建短移植肾动脉的经验。
一名27岁男性因终末期肾病被转诊至我院进行亲属活体肾移植。供者是他的母亲。最后，计划进行腹腔镜供肾切除术。在肾动脉解剖过程中发生大量腹腔内出血。进行了紧急干预以维持移植肾的通畅并稳定供者。出血得到控制。供肾切除术在剩余短段肾动脉的情况下完成。我们决定使用同侧性腺静脉延长移植肾动脉。进行了端端吻合。在延长移植肾动脉后，与髂内动脉进行了吻合。移植手术成功完成。肾脏立即发挥功能。多普勒超声显示肾脏灌注正常。受者术后肌酐水平在正常范围内。每日尿量正常。关于使用性腺静脉延长移植肾动脉的文献报道不足。
使用性腺静脉延长剩余的短移植肾动脉似乎是一种简单、安全且可靠的方法。该技术为活体供肾移植中短肾动脉的重建提供了一种替代方法。
