Cadaver Kidney Transplantation and Vascular Anomalies: A Pediatric Experience

Coppi, Paolo De; Giuliani, Stefano; Fusaro, Fabio; Zanatta, Cinzia; Zacchello, Graziella; Gamba, Piergiorgio; Zanon, Giovanni Franco

doi:10.1097/01.tp.0000236043.73906.25

Cited by 16 publications

(14 citation statements)

References 11 publications

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“…(11) published a large retrospective, single‐center experience of nearly 1000 kidney transplants, suggesting that transplanted kidneys with multiple renal arteries were associated with equivalent outcome when compared to kidneys having a single artery. Others have made similar observations in both adult and pediatric recipient populations (10, 12, 16, 22–25).…”

Section: Discussionsupporting

confidence: 52%

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Outcome of living kidney donors left with multiple renal arteries

Rizzari¹,

Suszynski²,

Gillingham³

et al. 2011

Clinical Transplantation

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Individuals with kidneys having ≥2 arteries appear to have an increased incidence of hypertension. Whether kidney donors in whom the remaining kidney has ≥2 arteries are at increased risk of hypertension is unknown. Therefore, we studied 3685 kidney donors to determine whether donors left with a kidney having ≥2 arteries were at increased risk of hypertension, impaired renal function, or death. Cohorts were assigned based on our practice pattern and the anatomy of the donated kidney. Of the 3685 donors, 1211 were estimated to have a remaining kidney with ≥2 arteries. Mean follow-up time for the single-artery group was 14.1 (±11.0) yr and 15.3 (±11.2) yr for the ≥2 artery group. Six-month hospital readmission rate was 1.4% and 1.2%, hypertension was noted in 22.4% and 21.8% and proteinuria in 9.7% and 9.6%, and estimated glomerular filtration rate at last follow-up was 62 (±28) and 62 (±16) for single vs. ≥2 renal artery groups, respectively. Our data suggest no adverse clinical sequelae nor any decrease in long-term survival for donors left with a kidney having ≥2 renal arteries.

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Section: Discussionsupporting

confidence: 52%

“…Based upon autopsy data, the frequency of multiple renal arteries in the general population has been estimated to occur at a rate of 18–30%, and more recent studies involving both cadaveric and living donors approximate the frequency of multiple arteries to be between 19% and 22% (15–18).…”

Section: Discussionmentioning

confidence: 99%

Outcome of living kidney donors left with multiple renal arteries

Rizzari¹,

Suszynski²,

Gillingham³

et al. 2011

Clinical Transplantation

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“…Another original finding in our population was the association between lymphocele and the risk of losing the graft in the first‐year post‐kidney transplantation. This is described in a pediatric study for the first time, but it was published before in adult literature, and so, in case of early signs and symptoms of lymphocele, there is an indication to perform an urgent ultrasound scan of the graft . Small and asymptomatic collections are often present immediately after the transplant, and it is not easy to confirm whether they are bleeding, infective, or lymphatic in nature.…”

Section: Discussionmentioning

confidence: 99%

Lymphocele after pediatric kidney transplantation: Incidence and risk factors

Giuliani

Gamba

Kiblawi

et al. 2014

Pediatric Transplantation

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Lymphocele is a well-known postoperative complication after kidney transplantation. The aim of this study was to analyze time trend incidence, risk factors, and outcome of post-transplant lymphocele in a large pediatric cohort. This is a retrospective single institution review of 241 pediatric kidney transplants performed from 2000 to 2013. Etiology of end-stage renal disease, recipient age and gender, transplant year, BMI percentile for age, type of dialysis, living/non-living related donor, acute rejection, and multiple transplantations were analyzed in association with lymphocele formation. Fourteen of 241 (5.81%) children developed a postoperative lymphocele. There has been a reduction in the incidence of lymphocele after 2006 (3.22% vs. 8.55%, p < 0.05). Significant risk factors for lymphocele were older age (≥11 yr), transplant before 2006, male gender, BMI percentile for age ≥95%, and multiple transplantations (p < 0.05). The one-yr graft survival was significantly reduced in the group with lymphocele compared with control (81.2% vs. 92.51%, p < 0.04). This is the first pediatric report showing the following risk factors associated with post-transplant lymphocele: age ≥11 yr, male gender, BMI for age ≥95%, and multiple transplantations. A lymphocele can contribute to graft loss in the first-year post-transplant.

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“…No other risk factors such as preservation solution, cold ischaemia duration, delayed graft function, living donation of kidney, graft vascular anomalies or vascular bench surgery have yet been incriminated as a cause of thrombosis (29, 40). No statistical difference in outcome has been observed for kidneys with multiple vessels (40).…”

Section: Discussionmentioning

confidence: 99%

Renal transplantation in children: Critical analysis of age related surgical complications

Irtan¹,

Maisin²,

Baudouin³

et al. 2010

Pediatric Transplantation

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To determine age-related risk factors of urological and vascular complications. We performed a retrospective analysis of the data of 202 renal transplantations in 193 children between 1989 and 2007 at a single institution. Out of 193 grafts (combined renal and liver grafts were excluded), we observed urological complications in 42 cases (21.7%) leading to graft loss in one case and vascular complications in 27 cases (13.9%) leading to graft loss in seven. The urological complications were VUR (n=25, 12.4%), ureteral stricture (n=10, 5%), anastomotic leak (n=4, 2%), ureteral necrosis (n=2, 1%), and incrustative pyelitis (n=1, 0.5%). Vascular complications were arterial stricture (n=14, 7.2%), arterial thrombosis (n=4, 2%), venous thrombosis (n=2, 1%), and others (n=7). Donors aged less than six yr were a risk factor of vascular complications leading to graft loss (p=0.0001), whereas patients with PUV had more urological complications (p=0.001). Overall patient and graft survival is 93.1% and 84% at five yr, respectively. Surgical complications remain a major cause of graft loss (12%) and morbidity in children's kidney transplantation (38.9%). Young age of donors is the major risk factor of early graft loss as a result of vascular complication. However, donor selection based on age is limited by the shortage of organs.

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Cadaver Kidney Transplantation and Vascular Anomalies: A Pediatric Experience

Cited by 16 publications

References 11 publications

Outcome of living kidney donors left with multiple renal arteries

Outcome of living kidney donors left with multiple renal arteries

Lymphocele after pediatric kidney transplantation: Incidence and risk factors

Renal transplantation in children: Critical analysis of age related surgical complications

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