Department of urology and renal transplantation, Sorbonne University, Pitié Salpêtrière University Hospital, AP-HP, 83, boulevard de l'hôpital, 75013 Paris, France.
Department of urology and renal transplantation, Sorbonne University, Pitié Salpêtrière University Hospital, AP-HP, 83, boulevard de l'hôpital, 75013 Paris, France.
Morphologie. 2022 Feb;106(352):15-22. doi: 10.1016/j.morpho.2021.01.005. Epub 2021 Mar 18.
Renal arterial vasculature presents a great anatomical variation. A good knowledge of this anatomy is essential in the field of kidney transplantation. The aim of this study is to describe the anatomical variations of the renal arterial vasculature based on the retrieved but not transplanted kidneys (RNTK) and their contralateral grafted kidneys (CGK), which anatomy is described by surgeons themselves after aortic dissection during multi-organ procurement (MOP).
Using the "Crystal" database of the French "Agence de la biomédecine" (ABM), all RNTK were retrospectively selected over one year. Then, the arterial anatomy of each RNTK and their CGK was studied using the surgical and the histopathological reports. The surgical report was completed by the surgeon at the end of the MOP from deceased donors. The qualitative variables were expressed in numbers (percentage of the population) and were compared by a Chi test or an exact Fisher test depending on the sample size. A P-value of less than 0.05 was considered statistically significant.
In total, 356 kidneys were studied (241 RNTK - 115 CGK), 69% had a single artery and 31% had multiple arteries (26% with two arteries and 5% with three or more). The incidence of multiple arteries was similar between the right and left kidneys (32% vs. 30% respectively). A modal arrangement with 1 artery on each side was present in 51% of cases. Thus, 1 in 2 donors had at least 2 arteries on one side. Multiple arteries were bilateral in 12% of cases. The RNTK group presented more kidneys with multiple arteries than the CGK group (35% vs. 22%).
Our study shows a higher incidence of multiple renal arteries than the literature (31% vs. 25%). Thus, MOP can be considered as an accurate and reliable method of describing renal arterial anatomy, especially that some small arteries may be missed when using radiological or cadaveric dissection techniques.
肾动脉血管呈现出巨大的解剖学变异。充分了解这一解剖结构对于肾脏移植领域至关重要。本研究旨在基于接受但未移植的肾脏（RNTK）及其对侧移植肾脏（CGK）描述肾动脉血管的解剖变异，这些解剖结构由外科医生在多器官获取（MOP）期间进行主动脉夹层后自行描述。
使用法国“生物医学机构”（ABM）的“Crystal”数据库，在一年的时间内回顾性选择所有 RNTK。然后，使用外科和组织病理学报告研究每个 RNTK 和其 CGK 的动脉解剖结构。外科报告由 MOP 期间死亡供体的外科医生在手术结束时完成。定性变量以数字（人群中的百分比）表示，并根据样本量通过卡方检验或确切 Fisher 检验进行比较。P 值小于 0.05 被认为具有统计学意义。
共研究了 356 个肾脏（241 个 RNTK-115 个 CGK），69%有单一动脉，31%有多条动脉（26%有两条动脉，5%有三条或更多条动脉）。左右肾脏的多动脉发生率相似（分别为 32%和 30%）。51%的情况下，每侧有 1 条动脉呈模态排列。因此，每 2 个供体中就有 1 个至少有 1 侧有 2 条以上动脉。12%的情况下，多动脉为双侧。RNTK 组的多动脉肾脏比 CGK 组多（35%比 22%）。
我们的研究表明，多肾动脉的发生率高于文献（31%比 25%）。因此，MOP 可被视为描述肾动脉解剖结构的准确可靠方法，特别是在使用放射学或尸体解剖技术时可能会遗漏一些小动脉。
