Cardiovascular and Thoracic Center, Viet Duc University hospital, Hanoi, 100000, Vietnam.
Organ Transplantation Center, Viet Duc University hospital, Hanoi, 100000, Vietnam.
Langenbecks Arch Surg. 2024 Nov 26;409(1):358. doi: 10.1007/s00423-024-03544-0.
Inverted kidney transplant (KT) has been applied in many transplant centers, but the experiences and outcomes of this technique was limited.
To describe the technical characteristics, indications and evaluate the outcomes of inverted kidney transplantation.
Retrospective study from January 2016 to December 2023, included 74 patients who underwent inverted kidney transplantation with 72 cases of right kidney transplant into the right iliac fossa and 2 cases of left kidney transplant into the left iliac fossa performed in Viet Duc University Hospital.
63 cases in stage 1 (ipsilateral kidney transplant), all kidney graft were transplanted on the same side and 11 cases in stage 2 in which the kidney transplant was performed in some special cases such as recipients with severe atherosclerotic iliac arteries or incompatibility between the arteries and venous. The operation time was significantly higher (192.8 vs. 173.7 min, p = 0.037). However, the kidney function showed no difference when being discharged and remained stable until the latest follow-up. 3-year graft survival was 98.3%. There was 1 case of graft loss due to chronic graft rejection- immunosuppression incompliance requiring retransplantation after 2 years. Main complications included acute pancreatitis (2.7%), and ureteral stenosis at the ureter-bladder junction (6.8%), not significantly different compared to conventional KT.
Inverted kidney transplantation is a simple, safe and effective technique and could be a feasible solution for some specific circumstances.
倒置式肾移植（KT）已在许多移植中心应用，但该技术的经验和结果有限。
描述倒置式肾移植的技术特点、适应证，并评估其结果。
回顾性研究，纳入 2016 年 1 月至 2023 年 12 月在越德大学医院接受倒置式肾移植的 74 例患者，其中 72 例右肾移植入右侧髂窝，2 例左肾移植入左侧髂窝。
63 例为 1 期（同侧肾移植），所有移植肾均移植在同一侧，11 例为 2 期，肾移植在一些特殊情况下进行，如供者有严重的髂动脉粥样硬化或动静脉不匹配。手术时间明显延长（192.8 分钟比 173.7 分钟，p=0.037）。然而，出院时的肾功能无差异，且在最新随访时保持稳定。3 年移植物存活率为 98.3%。1 例因慢性移植物排斥反应-免疫抑制剂不依从性导致移植肾丢失，2 年后需要再次移植。主要并发症包括急性胰腺炎（2.7%）和输尿管-膀胱吻合口输尿管狭窄（6.8%），与常规 KT 相比无显著差异。
倒置式肾移植是一种简单、安全、有效的技术，可为某些特殊情况提供可行的解决方案。
