Vessel Disposition Technique in Kidney Transplantation: Long-term Follow-up at Cho Ray Hospital, Vietnam

Abstract

In this clinical serial, we would like to introduce a surgical technique for kidney transplantation (KTx) from living donor (LD); we call the vessel disposition technique (VDT), with long-term follow-up results. A prospective study at Cho Ray Hospital. The patients underwent the KTx from 1998-2011 and following-up until 2016. There were 201pts., 130 males (64.7%) and 71 females (35.3%). Average age is 33.56 ± 8.62 year old (yo), [15 to 61yo]. We divided it into two groups (at the back table and recipient surgical table): Group A: The Kidney graft (KG) with short vein (≤20 mm) was transplanted on right iliac fossa: 63/201pts. (31.34%), 13/63 from the left (20.63%) and 50/63 from the right (79.37%): the renal vein was dissected, liberated and prolonged; for the right KG, a renal VDT would be done. On the pts., right Gibson incision, made an iliac VDT: dissection of the right iliac vessels (RIV), moved the external iliac vein (IV) to the right side of the external iliac artery; and a termino-lateral venous anastomosis. The renal artery anastomosis would be done as usual. Group B: The KG with the long vein enough (>20 mm) was also transplanted on RIF: 138/201pts (68.66%). Usually, the KG is the left, the KTx was performing as usual, vascular postoperative follow-up by Doppler ultrasound. There wasn't any surgical vascular complication during the average FU of: 8.0±3.44 years (group A) and 8.79±4.07 years (group B). During the long time follow-up on the serial, the VDT was satisfactory. The KTx from LD was safety for the short KG vein and we could perform on the right side of the pts for the left and the right KG. We could avoid other risky venous reconstructive techniques.