Kim Mi-Hyeong, Jun Kang-Woong, Moon In-Sung, Kim Ji-Il
Division of Vascular and Transplantation Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ann Surg Treat Res. 2016 Nov;91(5):260-264. doi: 10.4174/astr.2016.91.5.260. Epub 2016 Oct 31.
Congenital anomalies of the inferior vena cava (IVC) are rare but important problems in living donors for kidney transplantation, especially in cases of a short left renal vein and accompanying vascular and urological anatomic variations. However, the clinical impacts of IVC anomalies in deceased donors have yet to be reported. The unexpected presence of an IVC in an unusual position poses challenges to surgeons and increases the risk of bleeding during organ removal. Accompanying vascular variations can cause unexpected bleeding and injury and therefore technical complications in procurement and subsequent implantation. During cold perfusion, inadequate venous drainage or insufficient cooling can induce graft damage. Our cases highlight the need for all transplant surgeons to confirm the anatomy of the aorta, IVC, and major vessels early in the surgical procedure and, should an anomaly be detected, know how to manage the problem.
下腔静脉（IVC）先天性异常在活体肾移植供体中虽罕见但却是重要问题，尤其是在左肾静脉短且伴有血管和泌尿系统解剖变异的情况下。然而，IVC异常在已故供体中的临床影响尚未见报道。IVC出现在异常位置会给外科医生带来挑战，并增加器官切除过程中出血的风险。伴随的血管变异可导致意外出血和损伤，从而在获取及后续植入过程中引发技术并发症。在冷灌注期间，静脉引流不足或冷却不充分可导致移植物损伤。我们的病例强调所有移植外科医生都需要在手术早期确认主动脉、IVC和主要血管的解剖结构，并且一旦发现异常，要知道如何处理该问题。
