Fate of Accessory Renal Arteries in Grafts with Multiple Renal Arteries during Live-Donor Renal Allo-Transplantation

Harraz, Ahmed M.; Shokeir, Ahmed A.; Soliman, Shady; El‐Hefnawy, Ahmed S.; Kamal, Mohamed M.; Shalaby, Ibrahim; Kamal, Ahmed; Ghoneim, Mohamed A.

doi:10.1016/j.transproceed.2013.02.030

Cited by 7 publications

(2 citation statements)

References 23 publications

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“…Preoperatively, donors were evaluated by technetium‐99m mercaptoacetyltriglycine renography to determine the differential renal function according to a standardized protocol. Renal vascular anatomy was determined using contrast‐enhanced computed tomography scan or MRA . All donors were operated by a standard open donor nephrectomy by a supracostal flank approach.…”

Section: Methodsmentioning

confidence: 99%

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Salvage of grafts with vascular thrombosis during live donor renal allotransplantation: A critical analysis of successful outcome

et al. 2014

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Abbreviations & Acronyms CIA = common iliac artery EIA = external iliac artery EIV = external iliac vein HLA = human leukocyte antigen IIA = internal iliac artery IVC = inferior vena cava LDRTx = live donor renal allotransplantation MRA = magnetic resonance angiography RAT = renal artery thrombosis RVT = renal vein thrombosis Tx = transplantation US = ultrasound WIT = warm ischemia time Objectives: To report a high-volume institution experience with salvage techniques for vascular accidents during live donor renal allotransplantation. Methods: Between March 1976 and January 2011, 2208 recipients underwent live donor renal allotransplantation. A retrospective review of recipients with vascular accidents -renal artery thrombosis and renal vein thrombosis -was carried out. Salvage procedures were recorded and their outcomes were assessed. Results: A total of 23 (1%) vascular accidents occurred, including renal artery thrombosis and renal vein thrombosis in 19 (0.8%) and four (0.18%) recipients, respectively. All renal artery thrombosis patients were treated by open revascularization and the graft was salvaged in 12 patients (63%). Two renal vein thrombosis events were resolved by percutaneous catheterdirected thrombolytic therapy. Of the other two allografts, one was salvaged by thrombectomy and revascularization, and the other was lost. On univariable analysis, older recipients (P = 0.003), pretransplant hypertension (P = 0.001), more human leukocyte antigen mismatches (≥3; P = 0.036), shorter ischemia time (≤45 min; P = 0.004) and longer time to diagnosis (>3.5 days; P = 0.013) were significantly associated with non-salvage of the graft after vascular accidents. Nevertheless, none of these variables were significant on the multivariable analysis. Over a median follow up of 35 months, the median (range) serum creatinine was 2 mg/dL (range 0.8-8.8 mg/dL), and 11 (79%) recipients were living with functioning grafts. Conclusions: Despite the devastating complications, vascular accidents are salvageable and revascularization is crucial for graft salvage. Angiographic percutaneous techniques are viable alternatives for renal vein thrombosis.

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Section: Methodsmentioning

confidence: 99%

“…Renal vascular anatomy was determined using contrast-enhanced computed tomography scan or MRA. 12 All donors were operated by a standard open donor nephrectomy by a supracostal flank approach. Intraoperative medication and fluid management was described previously.…”

Section: Introductionmentioning

confidence: 99%

Salvage of grafts with vascular thrombosis during live donor renal allotransplantation: A critical analysis of successful outcome

et al. 2014

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The accessory renal arteries: A systematic review with meta‐analysis

Triantafyllou,

Paschopoulos,

Węgiel

et al. 2024

Clinical Anatomy

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The accessory renal arteries (ARAs) are a well‐described variant of the renal vasculature with clinical implications for radiologists, surgeons, and clinicians. The aim of the present systematic review with meta‐analysis was to estimate the pooled prevalence of ARAs, including their variant number, origin, and termination, and to highlight symmetrical and asymmetrical morphological patterns. The systematic review used four online databases in accordance with PRISMA 2020 and Evidence‐based Anatomy Workgroup guidelines. R programming software was used for the statistical meta‐analysis. A total of 111 studies were considered eligible for our initial aim. The typical renal artery (RA) anatomy (a single bilateral vessel) was identified in 78.92%; the overall ARA prevalence was estimated at a pooled prevalence of 21.10%. The estimated pooled prevalence of one, two, three, and four ARAs were 18.67%, 1.80%, 0.01%, and <0.01%. The ARAs have been the subject of extensive research owing to their clinical importance, including in kidney transplantation surgery and resistant hypertension therapy. Knowledge of the typical and variant anatomy of RAs is essential for anatomists, radiologists, surgeons, and clinicians in order to avoid misunderstanding, complications, and iatrogenic injury.

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A 2-mm Cutoff Value Is Reasonable and Feasible for Vascular Reconstruction in a Kidney Allograft With Multiple Arteries

Iwami

Hotta

Sasaki

et al. 2019

Transplantation Proceedings

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Fate of Accessory Renal Arteries in Grafts with Multiple Renal Arteries during Live-Donor Renal Allo-Transplantation

Cited by 7 publications

References 23 publications

Salvage of grafts with vascular thrombosis during live donor renal allotransplantation: A critical analysis of successful outcome

Salvage of grafts with vascular thrombosis during live donor renal allotransplantation: A critical analysis of successful outcome

The accessory renal arteries: A systematic review with meta‐analysis

A 2-mm Cutoff Value Is Reasonable and Feasible for Vascular Reconstruction in a Kidney Allograft With Multiple Arteries

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