Takahashi A, Satoh S, Nakai I, Kitaura K, Wada Y, Oka T
Second Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Sep;43(9):1553-8.
Out of twenty-five patients operated on for dissecting aneurysm in our institution since January 1991, four patients had autotransplantation of the kidney. The renal autotransplantation and the segmental replacement of the descending aorta with the prosthesis were done at the same time in three of them, and segmental replacement of the distal aortic arch was followed by autotransplantation because of the postoperative acute renal failure in the other one. Postoperative renal function of simultaneously operated patients was good whereas the patient who had been treated by two-staged operation needed hemodialysis for two weeks after the autotransplantation. Postoperative scintigraphy showed fully recovered function of the autotransplanted kidneys with enlargement. CT scan showed that the false lumen of the dissecting aorta was reduced in size with increased intraluminal clot formation. Renal autotransplantation with entry closure is easy and safe technique and assures successful operative results for the dissecting aneurysm, restoring impaired renal blood flow.
自1991年1月起，在我院接受夹层动脉瘤手术的25例患者中，有4例进行了自体肾移植。其中3例同时进行了肾自体移植和降主动脉节段性人工血管置换，另1例因术后急性肾衰竭，在远端主动脉弓节段性置换后进行了自体肾移植。同期手术患者术后肾功能良好，而接受两阶段手术的患者在自体肾移植后需要进行两周的血液透析。术后闪烁扫描显示自体移植肾的功能完全恢复且体积增大。CT扫描显示，夹层主动脉的假腔缩小，腔内血栓形成增加。带入口封闭的肾自体移植是一种简单安全的技术，可确保夹层动脉瘤手术成功，恢复受损的肾血流。
