Safe and effective elongation of a short graft and multiple renal veins using the gonadal vein (cylindrical technique) in living donor kidney transplantation

Nakamura, Yuki; Dan, Kaori; Miki, Katsuyuki; Yokoyama, T.; Tanaka, Kiyo; Ishíi, Yasuo

doi:10.1016/j.tpr.2020.100047

Cited by 1 publication

(5 citation statements)

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“…Several methods have been proposed to maximize or add length to the right renal vein for easier anastomosis 5,7,8,13–15 . One proposed solution is optimizing the length of the right renal vein during procurement.…”

Section: Discussionmentioning

confidence: 99%

“…Most proposed options include adding length to the transected renal vein. One method is utilization of the donor gonadal vein procured during laparoscopic nephrectomy 7,8 . The gonadal vein is isolated on the back table, cut along the long axis, and sewn to form a cylinder or spiral 8 prior to end‐to‐end anastomosis to the donor renal vein while the graft remains on ice, increasing cold ischemia time.…”

Section: Discussionmentioning

confidence: 99%

“…One method is utilization of the donor gonadal vein procured during laparoscopic nephrectomy 7,8 . The gonadal vein is isolated on the back table, cut along the long axis, and sewn to form a cylinder or spiral 8 prior to end‐to‐end anastomosis to the donor renal vein while the graft remains on ice, increasing cold ischemia time. Published studies report good graft function post‐operatively with no vascular complications.…”

Section: Discussionmentioning

confidence: 99%

“…12 Several methods have been proposed to maximize or add length to the right renal vein for easier anastomosis. 5,7,8,[13][14][15] One proposed solution is optimizing the length of the right renal vein during procurement. During open donor nephrectomy, a vascular stapler can be utilized and the staple line oversewn to maximize length during the procedure, or a cuff of inferior vena cava can be taken and venotomy oversewn.…”

Section: Discussionmentioning

confidence: 99%

“…We previously described the use of right internal jugular vein extension grafts for right‐sided living donor kidney transplantation 5 . Other studies have recommended novel stapling techniques, 6 and use of autologous vessel grafts, 5 donor gonadal vessels, 7,8 or prosthetic grafts 9 to maximize vein length. An additional technique that is less described in the literature is the use of deceased donor vein grafts to lengthen right renal veins 10 .…”

Section: Introductionmentioning

confidence: 99%

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Deceased donor vein extension grafts for right living donor kidney transplantation

Meinders

Knight

Eagar

et al. 2023

Clinical Transplantation

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IntroductionIn an effort to maximize living donor kidney utilization, we describe the use of deceased donor vein extension grafts for right‐sided living donor kidneys and report our single‐center experience using this technique.MethodsA retrospective review of kidney transplant recipients (KTR) who received a right living donor kidney with deceased donor vein extension graft. Recipient demographics, postoperative graft function, and surgical complications were reviewed. Living donor nephrectomies were performed laparoscopically. Vein grafts were obtained from recent deceased donor procurements. End‐to‐end anastomosis of the graft to the renal vein was performed prior to implantation.ResultsThirty‐eight KTR received a right kidney transplant with deceased donor extension grafts. The median recipient age and BMI were 53.0 years and 29.3 kg/m2. Total 71% were male. Ninety‐five percent of grafts displayed immediate graft function, with two recipients requiring temporary dialysis due to anaphylaxis from induction therapy. Median serum creatinine at two weeks was 1.6 mg/dL and at three months was 1.5 mg/dL. There were no graft thromboses.ConclusionUtilization of deceased donor extension grafts for short right renal veins is a simple technique that expands the donor pool for living donor renal transplantation. Our experience resulted in no technical complications and excellent early graft function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%