Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, China.
Clin Transplant. 2019 Apr;33(4):e13493. doi: 10.1111/ctr.13493. Epub 2019 Mar 18.
This retrospective study aims to describe novel ways of repair kidney allograft artery rupture secondary to infection using a preprocessed homologous "Y"-shaped iliac artery.
Five patients' whose course was complicated by graft arterial rupture were included in the rupture group, and patients who received the kidney from the same donor were included in the control group. In the rupture group, the iliac artery used for revascularization was harvested from a DCD donor, pre-treated with absolute diethyl ether, followed by absolute alcohol, and then preserved in 75% alcohol. A biopsy of the arterial graft was obtained and stained using hematoxylin and eosin (H&E). Once a patient was diagnosed with kidney allograft arterial rupture by ultrasound, emergency surgery was conducted and the preprocessed "Y"-shaped iliac artery was used for bridging.
Five patents were included in the rupture group. The "Y"-shaped iliac artery grafts were successfully preprocessed, H&E staining and electron microscope observation revealed few visible nuclei, with karyorrhexis and karyolysis. There were no significant differences in the long-term graft survival between two groups.
In conclusion, using preprocessed homologous "Y"-shaped iliac artery provides a useful method to bridge the vascular defects from kidney graft artery rupture secondary to infection in renal allograft recipients.
本回顾性研究旨在描述使用预处理同源“Y”形髂动脉修复感染性肾移植动脉破裂的新方法。
破裂组纳入 5 例因移植动脉破裂而导致病程复杂化的患者,对照组纳入接受同一供体供肾的患者。在破裂组中,用于血管重建的髂动脉取自 DCD 供体,用绝对乙醚预处理,然后用绝对乙醇处理,再保存在 75%乙醇中。对动脉移植物进行活检,并使用苏木精和伊红(H&E)染色。一旦患者通过超声诊断为肾移植动脉破裂,即进行急诊手术,并使用预处理的“Y”形髂动脉进行桥接。
破裂组纳入 5 例患者。“Y”形髂动脉移植物成功预处理,H&E 染色和电子显微镜观察显示可见核数较少,有核碎裂和核溶解。两组患者的长期移植物存活率无显著差异。
总之,使用预处理同源“Y”形髂动脉为肾移植受者因感染导致的肾移植动脉破裂提供了一种有用的方法来桥接血管缺陷。