The Role of Intraoperative Heparin in Cyclosporine Treated Cadaveric Renal Transplant Recipients

Mohan, Ponnusamy; Murphy, Denis; Counihan, Aileen; Cunningham, Phyllis M.; Hickey, David P.

doi:10.1097/00005392-199909010-00012

Cited by 32 publications

(12 citation statements)

References 5 publications

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“…Ubhi et al [13] recommend routine prophylactic heparinization while in the multivariate analysis performed by Bakir et al [14] , having a history of a previous venous thrombosis in the recipient, presence of diabetic nephropathy or hemodynamic disturbances, peroperative technical problems, and being a right kidney donor are described as high-risk conditions and heparinization is recommended in such cases [13,14] . Furthermore, Mohan et al [15] underline the fact that routine heparinization will increase the risk of bleeding. We only perform heparinization in cases carrying the risk of thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Surgical Approach to Cases with Multiple Renal Arteries in Renal Transplantation

Bakırtaş

Güvence²,

Eroğlu³

et al. 2006

Urol Int

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Aim: To evaluate the effect of multiple renal artery (MRA) presence on the success and complication rate of renal allotransplantation. Patients and Methods: We retrospectively analyzed 187 cases (128 men and 59 women) who were transplanted in our department from 1997 to 2005. 28 of these cases had MRA. Of MRA kidneys, 6 were obtained from cadavers and 22 from live donors. When the types of anastomoses for MRA cases were examined, 4 cases were anastomosed after being connected to the main polar artery with ex vivo bench surgery; the others had in vivo anastomosis. The patients were divided into two groups as single (group 1) and MRA (group 2) groups. Following the transplantation, creatinine levels, ATN ratios, development of hypertension, patient and graft survivals and vascular and urological complications were compared between the two groups. Results: Patient and graft survival rates were compared between the two groups in the first and third post-operative years. In the first year, graft survival rates for groups 1 and 2 were 94.9 and 92.9% respectively, whereas in the third year these were calculated as 88 and 85.7%. Concerning patient survival, first year results for groups 1 and 2 were 92.5 and 89.2%, for the third year these were found to be 84.9 and 82.1%. Mean creatinine levels of both groups were compared in the first and third years. The results for groups 1 and 2 were 1.41 ± 0.37 and 1.46 ± 0.46 mg/dl respectively for the first year. In the third year these were found to be 1.60 ± 0.43 and 1.69 ± 0.49 mg/dl and there was no statistically significant difference between the groups. Vascular and urological complications were observed in only 6 out of 187 cases (3.2%). Conclusions: No significant difference has been observed between single and MRA kidneys considering the success and complication rates of renal allotransplantation.

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Section: Discussionmentioning

confidence: 99%

Surgical Approach to Cases with Multiple Renal Arteries in Renal Transplantation

Bakırtaş

Güvence²,

Eroğlu³

et al. 2006

Urol Int

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“…All patients who had KTA received cyclosporin, azathioprine and corticosteroids as described previously 17 . Cyclosporin levels were maintained between 200 and 300 ng/ml (Homogeneous Enzyme Immunoassay; Emit  2000 cyclosporin specific assay; SYVA, Dade Behring Inc., Cupertino, USA) for the first 6 weeks after transplantation; levels were maintained between 150 and 250 ng/ml thereafter.…”

Section: Between 1 Januarymentioning

confidence: 99%

Improved patient survival in recipients of simultaneous pancreas–kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end-stage renal disease

Mohan

Safi

Little

et al. 2003

British Journal of Surgery

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“…After discontinuation of this practice no similar episodes were encountered, although we continued to heparinize temporarily during the operation. In recent experience from a cadaveric renal transplant recipient, the use of heparin did show to increase postoperative blood transfusion requirements [31]. Extrapolating these data to renovascular surgery may be simplistic, but worth noting to avoid postoperative bleeding.…”

Section: Discussionmentioning

confidence: 98%

Surgery for Renovascular Diseases: A Single-Center Experience in Revascularizing Renal Artery Stenosis and Aneurysm

et al. 2002

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Objective: Diagnosis and management of renovascular diseases (RVD) at Hokkaido University Hospital was reviewed with particular emphasis on surgical revascularization (SR). Patients and Methods: We studied a total of 33 patients with RVD [16 patients with renal artery stenosis (RAS): group 1, and 17 patients with renal artery aneurysm (RAA): group 2, 10 males, 23 females, aged 9–69 years (median 46), unilateral 24, bilateral 9]. Functional diagnosis of RVD with regard to renovascular hypertension (RVH) was done with the captopril test (CP-T) and captopril-enhanced ^99mTc-DTPA (diethylenetriamine-pentaacetic acid) renal scintigraphy (CER). All were subjected to SR. Number, length, size and site of RVD with involvement of branch arteries dictated the choice of operative method but basically in situ repair for main trunk disease (11 kidneys) and ex vivo bench repair with autotransplantation for those beyond the first bifurcation intrarenally involving branched arteries (24 kidneys) were employed. The outcome was analyzed as to blood pressure control, split renal function, and branch renal artery patency. Results: (1) Sensitivity of CP-T and CER was 79 and 77% respectively in group 1, while it was 40 and 38% respectively in group 2. (2) Blood pressure was cured in 66.7% (group 1, 68.8% and group 2, 63.6%) and improved in 22.2% (group 1, 18.8% and group 2, 27.3%) with an overall success rate of 88.9%. (3) Renal function was good in 81.3% (group 1, 83.3% and group 2, 78.6%) and fair in 9.4% (group 1, 0% and group 2, 21.4%) with overall success in 90.7%. (4) Patency was preserved in 90.5% of branch anastomoses. Conclusions: Despite challenging complexities, SR of RVD is feasible with a reasonable amount of morbidity and effective in controlling blood pressure and preserving renal function in the majority of cases.

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The Role of Intraoperative Heparin in Cyclosporine Treated Cadaveric Renal Transplant Recipients

Abstract: Intraoperative heparin did not reduce the incidence of graft thrombosis in this retrospective study. It did increase the postoperative blood transfusion requirements. As a result of this analysis, we have abandoned its use.

Cited by 32 publications

References 5 publications

Surgical Approach to Cases with Multiple Renal Arteries in Renal Transplantation

Surgical Approach to Cases with Multiple Renal Arteries in Renal Transplantation

Improved patient survival in recipients of simultaneous pancreas–kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end-stage renal disease

Surgery for Renovascular Diseases: A Single-Center Experience in Revascularizing Renal Artery Stenosis and Aneurysm

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