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Best results in living donor transplantation using an aggressive policy in microsurgical bench reconstruction of nonoptimal arterial supply.

Abstract：

:The increasing of number of patients awaiting kidney transplantation have forced surgeons to use nonoptimal organs, such as kidneys with multiple/diseased arteries as well as those coming from living donors (LDs). Two hundred and sixty six LD transplants performed in cyclosporine era included 44 coming from a LD over 60 years of age. They were categorized into three groups according to the number of renal arteries and the surgical techniques employed for the arterial anastomosis: group I (n = 213) had a single "normal" renal artery. Group II (n = 11) were grafts with two (n = 10) or three (n = 1) arteries, which were directly reconstructed by intracorporeal conventional separate anastomoses. Group III of 42 recipients had grafts with either one artery affected by intrinsic renovascular disease (n = 18) or multiple arteries (n = 24) that were reconstructed at the bench. Recipient survival at 1 year was comparable, namely, 98%, 100%, and 100% rates in groups I, II, and III, respectively. Graft survivals not censored for death were 87%, 85%, 100% at 3 years for groups I, II, and III, respectively. The use of microvascular reconstructions ex vivo can widen the criteria for acceptance of LDs who display multiple or diseased renal arteries.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Berardinelli L

doi

10.1016/j.transproceed.2006.03.062

subject

Has Abstract

pub_date

2006-05-01 00:00:00

pages

991-3

issue

4

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(06)00357-5

journal_volume

38

pub_type

杂志文章

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