Multiple-Artery Renal Transplantation: Emphasis on Extracorporeal Methods of Donor Arterial Reconstruction

Novick, Andrew C.; Magnusson, Magnus O.; Braun, William E.

doi:10.1016/s0022-5347(17)56578-7

Cited by 60 publications

(27 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…19 Novic et al reported the incidence of multiple renal arteries as 23% and 10% for unilateral and bilateral cases respectively. 20 In a study on Turkish population in 18-30% of potential donors for renal transplantation multiple renal arteries were observed. 21 In another study representing Turkish population 90 fetuses were dissected after colored latex had been injected into the vessels.…”

Section: Resultsmentioning

confidence: 99%

A retrospective study on multiple renal arteries in Turkish population

Zağyapan¹,

Pelin²,

Kürkçüoğlu³

2009

Anatomy

View full text Add to dashboard Cite

Since the embryological development of urogenital system is highly complicated the congenital anomalies or variations of these organs are relatively higher when compared with the others. Structural or localization anomalies of the kidneys or vascular variations are various. Some of them do not even cause clinical symptoms and require treatment. However some of them are predisposing to some pathological disorders because of the decrease in the blood supply or urinary flow. 1Most of the anomalies are the persistent structures those do not disappear during the embryological process or occur due to a delay at the end of the development. AbstractObjectives: Since the urogenital system has a complicated embryological development the congenital anomalies and variations in these structures are common, and their incidence shows social, ethnic and racial difference. Especially the variations in the vascular structure of the kidneys gain importance because of the widespread development in transplantation surgery. This preliminary study is a retrospective archive study on multiple renal arteries, and represents the central Anatolian population. Our main purpose is to determine the incidence of multiple renal arteries in the central Anatolia region, and to evaluate their types.Methods: Angiographic images of 150 individuals were examined for the study. Results:The incidence of multiple renal arteries was observed as 42%. This result was a little higher when compared with the other studies on Turkish population, but correlated with general literature. Conclusion:These results indicate the need of a detailed radiological examination before the surgical approaches.

show abstract

Section: Resultsmentioning

confidence: 99%

A retrospective study on multiple renal arteries in Turkish population

Zağyapan¹,

Pelin²,

Kürkçüoğlu³

2009

Anatomy

View full text Add to dashboard Cite

show abstract

“…However, for unknown reasons, this process is often incomplete and multiple kidney arteries not so rare [26]. Knowledge of the variety of renal arteries should be a beacon in such vascular procedures as therapeutic embolisation and angioplasty, as well as management of renal ischaemia during transplantation [7,25]. Although multiple kidney artery transplants are burdened with some dose of risk, there is a consensus that the obtained results tend to be comparable to kidney transplantations with a single renal artery [1,3,12,39].…”

Section: Discussionmentioning

confidence: 99%

Investigations on renal vascularisation pathology in the Polish population. 1. Incidence of multiple kidney arteries

Sośnik¹,

Sośnik²

2017

Folia Morphol

View full text Add to dashboard Cite

“…Methods of renal artery reconstruction for a number of indications have been described previously [1,5,6,9]. Our report emphasizes the ex vivo techniques of repair following harvest injury of the renal artery.…”

Section: Discussionmentioning

confidence: 93%

“…All of the above-mentioned basic techniques can be used in combination (Figs. 5,6). One type-4 patient had the most extensive reconstruction known to have been performed in any renal recipient.…”

Section: Types Of Repairmentioning

confidence: 99%

Renal artery reconstruction for harvesting injuries in kidney transplantation with particular reference to the use of vascular allografts

Tzakis¹,

Mazzaferro²,

Pan³

et al. 1988

Transplant Int

View full text Add to dashboard Cite

Abstract. At the University of Pittsburgh during the calendar year 1986, an arterial injury occurred during harvesting in 20 (7.5%) of the 270 grafts used to perform kidney transplantation (KTx). Four cases required reconstruction, using extension iliac arterial allografts from cadaveric donors of the same blood type; 6 patients, remodelling of the aortic patch in multiple arteries; 4 cases, repairs for injuries to the smaller segmental/polar arteries; 6 cases, a combination of the above techniques. These ex vivo arterial reconstructions are described and the use of donor arterial homografts is emphasized. No deaths have occurred at an average follow-up of 19 months. The postoperative acute tubular necrosis (ATN) rate was significantly higher (90%) compared with non-reconstructed kidneys during the same year (30%). The 1-year graft survival of kidneys undergoing arterial reconstruction (75%) was statistically no different than the overall kidneytransplant survival. Whenever extension iliac allografts were utilized, the cyclosporin-steroid immunosuppression required to control the kidney rejection contributed to the long-term patency rate of the graft. Since the number of organs available for grafting is limited, reconstruction of injured renal vessels has become justified, allowing valuable kidneys to be used that would otherwise be lost.Key words: Arterial injury -Renal artery reconstruction -Kidney transplant.Kidney transplantation (KTx) has become the treatment of choice for end-stage renal disease. Because the number of organs available for grafting is Offprint requests to: T. E. Starzl limited, we have used kidneys that required simple or extensive vascular reconstruction in order to be transplantable. Previously, such organs had quite often been discarded. We report our own experience with reconstruction of the renal artery for cadaveric kidney transplantation, including the use of cadaveric iliac arterial grafts, during the calendar year 1986. Materials and method Case materialDuring 1986 at the University of Pittsburgh, 270 cadaveric renal transplantations were performed under cyc1osporin-steroid immunosuppression, to which OKT3 therapy was added when intractable rejection supervened. The blood now to the kidney was monitored postoperatively with a technetium renal scintigram. Twenty (7.5%) of the 270 grafts required arterial reconstruction. Eight of the grafts with arterial reconstruction were procured locally by our own surgeons; the other 12 were shipped in from other centers.Eighteen of the 20 donors were adults averaging 22 ± 15 (SO) years. Two pediatric donors were 6 and 8 years of age, respectively. Likewise, 18 of the 20 recipients were over 10 years old, averaging 30.4± 13 (SO) years; the only exceptions were two children 7 and 8 years of age, who received the two pediatric kidneys. Source of vascular allograftsIliac artery and vein grafts are taken at the time of multiple organ harvesting [9,10], usually in continuity with the terminal aorta and inferior vena cava. The grafts are preserved in T...

show abstract

Multiple-Artery Renal Transplantation: Emphasis on Extracorporeal Methods of Donor Arterial Reconstruction

Cited by 60 publications

References 5 publications

A retrospective study on multiple renal arteries in Turkish population

A retrospective study on multiple renal arteries in Turkish population

Investigations on renal vascularisation pathology in the Polish population. 1. Incidence of multiple kidney arteries

Renal artery reconstruction for harvesting injuries in kidney transplantation with particular reference to the use of vascular allografts

Contact Info

Product

Resources

About