背景:短收获右肾静脉(RV)在活体供肾移植(KT)中很常见。这种技术难题可能会干扰植入并增加热缺血时间。已经应用了克服这个问题的几种技术,包括髂静脉转位,倒置移植,合成接枝,隐静脉...伴随性腺静脉(GV)的应用,这很容易接近,耗时少,最近出版了。本研究旨在评估其有效性和安全性。
方法:于2019年4月至2022年4月在VietDuc大学医院对使用性腺静脉延长右肾短静脉的KT进行回顾性研究。收集了以下数据:基线特征,CT扫描/肾切除术后和重建后的血管成像(mm),重建和手术时间,住院天数。结果由移植后的肾功能决定(血浆肌酐,肌酐清除率)和相关并发症。
结果:收集了25例从活体供体获得右肾短RV的病例,并通过随附的GV进行了重建和延长。RV的附加长度为15.9±2.4mm。平均冷缺血时间,静脉成形术时间,热缺血时间分别为60.4±8.2、21.2±5.3和38.1±5.6分钟,分别。平均住院时间为15.3±3.2天。平均随访时间31±5.2个月,1年后肌酐清除率约为60毫升/分钟,未观察到血管或泌尿系统并发症。
结论:伴随来自活体供体的GV延长KT的短右心室是可行的,安全,和有效的技术。
BACKGROUND: Short harvested right renal veins (RV) are quite common in living donor kidney transplantation (KT). This technical difficulty might interfere implanting and increase warm ischemic time. Several techniques to overcome this problem have been applied, including iliac vein transposition, inverted transplant, synthetic graft, saphenous vein… Application of accompanying gonadal vein (GV), which is easily approachable and less time-consuming, has been recently published. This study aims to evaluate its effectiveness and safety.
METHODS: Retrospective study on KT using the gonadal vein to lengthen the short right renal vein at Viet Duc University Hospital from April 2019 to April 2022. The following data were gathered: baseline characteristics, vascular imaging in CT scan/after nephrectomy and after reconstruction (mm), reconstruction and surgical time, hospitalization days. The outcomes were determined by kidney function after transplantation (plasma creatinine, creatinine clearance) and related complications.
RESULTS: Twenty-five cases with procured right kidney with short RV from the living donor which were reconstructed and lengthened by the accompanying GV were collected. The additional length of RV was 15.9 ± 2.4 mm. Average cold ischemic time, venoplasty time, warm ischemic time were 60.4 ± 8.2, 21.2 ± 5.3, and 38.1 ± 5.6 min, respectively. The average hospital stay was 15.3 ± 3.2 days. Average follow-up time was 31 ± 5.2 months, creatinine clearance was around 60 ml/min after 1 year, no vascular or urologic complications was observed.
CONCLUSIONS: Accompanying GV from a living donor to lengthen short right RV in KT is a feasible, safe, and effective technique.