Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA.
J.C. Walter Jr Transplant Center, Houston Methodist Hospital, Houston, Texas, USA.
Clin Transplant. 2023 Aug;37(8):e14963. doi: 10.1111/ctr.14963. Epub 2023 Mar 20.
In an effort to maximize living donor kidney utilization, we describe the use of deceased donor vein extension grafts for right-sided living donor kidneys and report our single-center experience using this technique.
A retrospective review of kidney transplant recipients (KTR) who received a right living donor kidney with deceased donor vein extension graft. Recipient demographics, postoperative graft function, and surgical complications were reviewed. Living donor nephrectomies were performed laparoscopically. Vein grafts were obtained from recent deceased donor procurements. End-to-end anastomosis of the graft to the renal vein was performed prior to implantation.
Thirty-eight KTR received a right kidney transplant with deceased donor extension grafts. The median recipient age and BMI were 53.0 years and 29.3 kg/m . Total 71% were male. Ninety-five percent of grafts displayed immediate graft function, with two recipients requiring temporary dialysis due to anaphylaxis from induction therapy. Median serum creatinine at two weeks was 1.6 mg/dL and at three months was 1.5 mg/dL. There were no graft thromboses.
Utilization of deceased donor extension grafts for short right renal veins is a simple technique that expands the donor pool for living donor renal transplantation. Our experience resulted in no technical complications and excellent early graft function.
为了最大限度地利用活体供肾，我们描述了使用已故供体静脉延长移植物来处理右侧活体供肾，并报告了我们使用该技术的单中心经验。
回顾性分析了接受右侧活体供肾和已故供体静脉延长移植物的肾移植受者（KTR）。回顾了受者的人口统计学特征、术后移植物功能和手术并发症。活体供肾切除术采用腹腔镜进行。静脉移植物取自最近的已故供体采集。在植入前，进行移植物与肾静脉的端对端吻合。
38 名 KTR 接受了右侧带已故供体延长移植物的肾移植。中位受者年龄和 BMI 分别为 53.0 岁和 29.3kg/m2。71%的患者为男性。95%的移植物立即发挥功能，由于诱导治疗引起的过敏反应，有 2 名受者需要临时透析。两周时的血清肌酐中位数为 1.6mg/dL，三个月时为 1.5mg/dL。没有发生移植物血栓形成。
对于短右侧肾静脉，使用已故供体延长移植物是一种简单的技术，可以扩大活体供肾移植的供体池。我们的经验没有导致任何技术并发症，并获得了良好的早期移植物功能。
