Surgical Technique Notes of Arterial Vascular Reconstruction During Kidney Transplantation: Personal Experience and Literature Review

Giovanardi, Francesco; Nudo, F.; Lai, Quirino; Garofalo, M.; Consolo, A.; Janvry, E. Choppin De; Murillo, Gabriela Alfaro; Ursi, Pietro; Stabile, D.; Melandro, Fabio; Berloco, P.B.; Pretagostini, R.; Poli, L.

doi:10.1016/j.transproceed.2018.04.072

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Warm ischemia time has been found to result in significantly worse early graft function only after a threshold of approximately 45–60 min, which was not exceeded by most included studies reporting this outcome 38 . On the other hand, cold ischemia time, although a significant factor influencing delayed graft function in deceased donors was shown to not differ between MRA and SRA in LDKT in a study by Giovarnadi et al 39,40 …”

Section: Discussionmentioning

confidence: 95%

“…Warm ischemia time has been found to result in significantly worse early graft function only after a threshold of approximately 45-60 min, which was not exceeded by most included studies reporting this outcome. 38 On the other hand, cold ischemia time, although a significant factor influencing delayed graft function in deceased donors was shown to not differ between MRA and SRA in LDKT in a study by Giovarnadi et al 39,40 MRA grafts have even been suggested to be superior to right kidney nephrectomy (RKN) grafts due to the latter's tendency for vein thrombosis. 41 Among included studies, Chedid et al 17 found no significant differences in GS and OS between right and left donor kidneys.…”

Section: Discussionmentioning

confidence: 99%

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Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient‐level meta‐analysis

Lim

Fong

et al. 2023

Clinical Transplantation

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IntroductionGrafts with multiple renal arteries (MRAs) were historically considered a relative contraindication to transplantation due to the higher risk of vascular and urologic complications. This study aimed to evaluate graft and patient survival between single renal artery (SRA) and MRA living‐donor kidney transplants.MethodsAn electronic literature search was conducted on PubMed, EMBASE, and Scopus for prospective or retrospective studies comparing SRA versus MRA in living donor renal transplantation, with the provision of Kaplan–Meier curves for recipient overall survival (OS) or graft survival (GS). A graphical reconstructive algorithm was used to obtain OS and GS of individual patients, which was then pooled under random‐effects individual patient data (IPD) meta‐analysis using Cox‐models to determine hazard ratios (HRs) and 95% confidence intervals (CIs). Meta‐regression of baseline covariates versus HRs of OS and GS was performed for variables reported in 10 or more studies.ResultsFourteen studies were retrieved, of which 13 (8400 patients) reported OS and 9 (6912 patients) reported GS. There were no significant differences in OS (shared‐frailty HR = .94, 95%CI = .85–1.03, p = .172) or GS (shared‐frailty HR = .95, 95%CI = .83–1.08, p = .419) between SRA and MRA. This comparison remained non‐significant even when restricted to open‐ or laparoscopic‐only studies. Meta‐regression yielded no significant associations of GS with donor age, recipient age, and percentage of double renal arteries within the MRA arm.ConclusionsThe similar rates of GS and OS between MRA and SRA grafts suggest that there is no need for discrimination between the two when evaluating donors for nephrectomy.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient‐level meta‐analysis

Lim

Fong

et al. 2023

Clinical Transplantation

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“…The incidence of multiple renal arteries is about 17%-35% reported by autopsy studies, depending on the ethnic origin[ 12 ]. The use of renal grafts with multiple renal arteries is quite common clinically, due to the donor shortage[ 13 ]. Accessory arteries are usually ligated if the vascularizing area is less than 5%-10% of the kidney.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and spontaneous healing of asymptomatic renal allograft extra-renal pseudo-aneurysm: A case report

Xu¹,

He²,

Yi³

et al. 2021

WJCC

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BACKGROUND Transplant renal artery stenosis is a relatively frequent vascular complication after transplantation. However, extra-renal pseudo-aneurysms (EPSAs) are rare after transplantation; they can be life-threatening and usually need open surgical repair. We discuss the diagnosis and spontaneous healing of an asymptomatic renal allograft EPSA caused by renal artery anastomotic stenosis, which was diagnosed in a timely manner and managed by conservative treatments. CASE SUMMARY We present a 37-year-old male patient diagnosed with a renal allograft EPSA caused by renal artery anastomotic stenosis due to multiple atherosclerotic plaques with ultrasonographic examination 6 mo post transplantation. The stenosis rate of 90% and the EPSA were verified by computed tomography angiography. The diagnosis was further confirmed with digital subtraction angiography. Percutaneous transluminal angiography was conducted, and a metallic stent was successfully implanted at the stenosed site of the main renal artery trunk. No further intervention for the EPSA was undertaken due to the difficulty of stenting and the risk of bleeding; regular ultrasonographic follow-ups were recommended. The stenosis was significantly relieved immediately after stent implantation and the EPSA was healed spontaneously by completely filling with hypo-echoic thrombosis 8 mo after stenting. CONCLUSION Ultrasonography combined with a high-frequency linear probe can detect vascular complications post renal transplantation at an early stage and improve prognosis.

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Trasplante renal mediante reconstrucción de conducto vascular en riñones de donantes fallecidos con arterias renales múltiples y venas renales cortas

Alexander

Serena

González

et al. 2020

Actas Urológicas Españolas

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Surgical Technique Notes of Arterial Vascular Reconstruction During Kidney Transplantation: Personal Experience and Literature Review

Cited by 7 publications

References 14 publications

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient‐level meta‐analysis

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient‐level meta‐analysis

Diagnosis and spontaneous healing of asymptomatic renal allograft extra-renal pseudo-aneurysm: A case report

Trasplante renal mediante reconstrucción de conducto vascular en riñones de donantes fallecidos con arterias renales múltiples y venas renales cortas

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