中国组织工程研究

中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (18): 3263-3266.doi: 10.3969/j.issn.2095-4344.2013.18.005

• 肾移植 kidney transplantation • 上一篇    下一篇

移植肾血管变异的临床处理

黎  程1，方驰华2，申  升1，吴家清1，蒙善东1，周结学1，刘  东1   

  1. 1广东省第二人民医院器官移植科，广东省广州市  510317
    2南方医科大学珠江医院肝胆外科，广东省广州市  510282
  • 收稿日期:2012-12-16 修回日期:2013-04-07 出版日期:2013-04-30 发布日期:2013-04-30
  • 通讯作者: 方驰华，教授，博士生导师，南方医科大学珠江医院肝胆外科，广东省广州市 510282 fangch_dr@126.com
  • 作者简介:黎程☆，男，1973年生，广东省高州市人，汉族，南方医科大学在读博士，副主任医师，主要从事器官移植和外科仿真学研究。 182838li@163.com
  • 基金资助:

    国家高技术研究发展(863)计划(2006AA02Z346)；广东省自然科学基金团队项目(6200171)；国家自然科学基金(30470493)。

Clinical management of vascular variations in renal transplantation

Li Cheng1, Fang Chi-hua2, Shen Sheng1, Wu Jia-qing1, Meng Shan-dong1, Zhou Jie-xue1, Liu Dong1   

  1. 1 Department of Organ Transplantation, Guangdong No.2 Provincial People’s Hospital, Guangzhou  510317, Guangdong Province, China
    2 Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou  510282, Guangdong Province, China
  • Received:2012-12-16 Revised:2013-04-07 Online:2013-04-30 Published:2013-04-30
  • Contact: Fang Chi-hua, Professor, Doctoral supervisor, Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China fangch_dr@126.com
  • About author:Li Cheng☆, Studying for doctorate, Associate chief physician, Department of Organ Transplantation, Guangdong No.2 Provincial People’s Hospital, Guangzhou 510317, Guangdong Province, China 182838li@163.com
  • Supported by:

    National 863 Program for High-Tech Research and Development, No. 2006AA02Z346; Team Project of Guangdong Natural Science Foundation,
    No. 6200171; National Natural Science Foundation of China, No. 30470493

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摘要：

背景：血管吻合技术的好坏直接关系到肾移植的成败。
目的：提高肾移植变异血管吻合的技术方法。
方法：1999年9月至2010年12月广东省第二人民医院器官移植科共完成878例肾移植，对其中供肾存在的动静脉血管变异进行修整、合并、延长等重建处理后进行移植，副肾动脉采用改良支架支撑法同腹壁下动脉吻合。
结果与结论：878例肾移植中，55例供肾动脉变异，肾静脉变异22例，经血管修整重建后均成功与受者髂内或髂外血管吻合。23例直径大于1 mm副肾动脉与腹壁下动脉吻合均取得成功。移植后彩超显示肾动静脉吻合口血流及副肾动脉血流正常。提示移植肾血管变异及副肾动脉只要正确处理，吻合得当，可以安全有效地移植给受者并获良好效果。

关键词: 器官移植, 肾移植, 移植物, 血管变异, 供肾动脉变异, 肾静脉变异, 副肾动脉, 副肾动脉-腹壁下动脉吻合, 863项目

Abstract:

BACKGROUND: The vascular anastomosis technique is directly related to the success or failure of the renal transplantation.
OBJECTIVE: To improve the techniques of variable vascular anastomosis in renal transplantation.
METHODS: 878 cases received renal transplantation in the Department of Organ Transplantation, Guangdong No.2 Provincial People’s Hospital from September 1999 to December 2010 were selected, and the donor renal vascular variation including renal artery and renal vein were treated with trim, merge, extend and other reconstruction processes for renal transplantation, and the accessory renal arteries were anastomosed to inferior epigastric arteries by a modified stereotaxic method.
RESULTS AND CONCLUSION: Among the 878 renal transplantation cases, 55 donor kidneys had renal artery variation and 22 donor kidneys had renal vein variation. All the variable vessels were anastomosed to the internal iliac or external iliac vessels successfully after vascular reconstruction. Twenty-three cases of accessory renal arteries with the diameter of more than 1 mm were anastomosed to inferior epigastric arteries successfully. Color Doppler ultrasound image showed that blood stream was smooth in all anastomosed vessels. Transplant renal vascular variation and accessory renal arteries can be transplanted safely and effectively by correct vascular rebuilding or vascular anastomosis.

Key words: organ transplantation, renal transplantation, allograft, vascular variation, donor renal artery variation, donor renal vein variation, accessory renal artery, accessory renal artery-inferior epigastric artery anastomosis, National 863 Projects of China

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