Kumar Sunil, Mahajan Nikhil, Dasgupta Soham, Patil Shivakumar Shankarrao, Singh Sarbpreet, Kenwar Deepesh Benjamin, Singhal Manphool, Sharma Ashish, Lal Anupam, Minz Mukut
From the Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
Exp Clin Transplant. 2018 Dec;16(6):751-753. doi: 10.6002/ect.2016.0102. Epub 2017 Feb 23.
In renal transplant, multiple renal arteries in a donor require meticulous vascular reconstruction for successful allograft function in the recipient. Presence of more than 4 renal arteries is usually considered to be a relative contraindication for proceeding with renal donation. We report a living-donor renal transplant procedure where preoperative radiologic imaging of the donor showed 3 left renal arteries. Two additional arteries were identified intraoperatively. All 5 arteries were reconstructed during the back-table procedure, and the allograft was implanted in the recipient. At 3-month follow-up, computed tomographic imaging demonstrated patency of all 5 renal arteries, and the patient had a serum creatinine level of 0.8 mg/dL. Unidentified arteries on preoperative imaging may occasionally require complex reconstruction. A renal allograft with 5 renal arteries is usually a contraindication for renal donation. Here, we describe the first published case of successful kidney transplant after reconstruction of 5 renal arteries in the donor graft.
在肾移植中，供体存在多条肾动脉时，需要进行细致的血管重建，以使受体的同种异体移植物功能正常。通常认为肾动脉超过4条是进行肾脏捐献的相对禁忌证。我们报告了一例活体供肾移植手术，供体术前影像学检查显示有3条左肾动脉。术中又发现了另外两条动脉。在后台操作过程中对所有5条动脉进行了重建，然后将同种异体移植物植入受体。在3个月的随访中，计算机断层扫描成像显示所有5条肾动脉通畅，患者血清肌酐水平为0.8mg/dL。术前影像学检查未发现的动脉有时可能需要进行复杂的重建。具有5条肾动脉的同种异体肾通常是肾脏捐献的禁忌证。在此，我们描述了首例已发表的供体移植物中5条肾动脉重建后成功进行肾移植的病例。
