Navarro Del-Río Estephanía, Parmentier de-León Catherine, Chávez Villa Mariana, Carpinteyro Espín Paulina, Quintero-Quintero Marco José, Vilatobá Mario, Contreras Alan G, Cruz Martínez Rodrigo
Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico.
Transplant Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico.
Transplant Proc. 2020 May;52(4):1102-1105. doi: 10.1016/j.transproceed.2020.01.056. Epub 2020 Mar 20.
A short right renal vein (RRV) remains a challenge for renal transplant surgery, especially in the living donor. Different techniques exist to obtain an RRV with a suitable length in cadaveric donor; however, in living donors the options are limited.
We present 2 living kidney transplants in which we obtained a very short RRV, making the implantation very difficult. We describe our technique to overcome this problem by using cadaveric iliac vessels retrieved from previous cadaveric donations and preserved at 4°C in histidine-tryptophan-ketoglutarate (HTK) solution, without intraoperative or postoperative complications. We complied with the Helsinki Congress and the Istanbul Declaration regarding the donor source.
In both cases, kidney grafts had optimal primary function, with good creatinine clearance after transplant and good patency of vascular anastomosis by Doppler ultrasounds.
We believe the use of cadaveric vessel grafts in living donor kidney transplant is a valuable resource as a rescue tool in emergency situations like the ones being presented in this article in order to avoid discarding a kidney graft with damage or short vessels. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
右肾静脉(RRV)较短对肾移植手术来说仍是一项挑战,尤其是在活体供肾的情况下。在尸体供肾中存在不同技术来获取具有合适长度的RRV;然而,在活体供肾中选择有限。
我们介绍了2例活体肾移植,术中获取的RRV非常短,导致植入非常困难。我们描述了通过使用从之前尸体供肾获取并保存在4℃组氨酸 - 色氨酸 - 酮戊二酸(HTK)溶液中的尸体髂血管来克服这一问题的技术,且未出现术中或术后并发症。我们遵循了关于供体来源的赫尔辛基大会和伊斯坦布尔宣言。
两例中,肾移植均具有最佳的初期功能,移植后肌酐清除率良好,多普勒超声显示血管吻合通畅。
我们认为在活体供肾肾移植中使用尸体血管移植物作为救援工具是一种宝贵的资源,可用于应对本文所述的紧急情况,以避免丢弃受损或血管短的肾移植供肾。本研究未获得公共、商业或非营利部门的资助机构提供的任何特定资助。