Abstract:

BACKGROUND: Artery variations in living related renal transplantation occur frequently, so the methods of renovascular reconstruction should be paid more attention in order to make sure rationality and security of the surgery. In clinic, multiple arteries of the donor kidney are commonly found. Living related renal transplantation is at the early stage in China, and the related experience is few.
OBJECTIVE: To discuss application of renovascular reconstruction of multiple arteries during living related donor kidney transplantation.
METHODS: A total of 38 cases undergoing living related donor kidney transplantation from January 2006 to December 2008 were analyzed, including 30 cases in single renal artery group and 8 cases in multiple artery group. In multiple artery group, there were 5 cases of double arteries and 2 cases of three arteries and 1 case of four arteries. The multiple arteries were reconstructed by end to side or side to side conjoined anastomosis respectively, and then anastomosed the internal iliac artery or external iliac artery respectively.
RESULTS AND CONCLUSION: No blood transfusions were needed and no complications occurred in eight cases of multiple artery donors. The 8 donors were discharged from hospital at 7-10 days postoperatively. Follow-up examinations were for 6-36 months (mean 13 months). Renal tubule necrosis, renal artery embolism, renal pseudoaneurysm, and vascular stenosis, were not found. The color Doppler ultrasound examination showed that the transplanted kidney had good blood supply. There was no significant difference in the time of urine secretion, serum creatinine level between the multiple arteries group and the single artery group (P > 0.05). These indicated that blood vessel reconstruction using a suitable method cannot affect outcomes of renal transplantation. It is feasible to reconstruct blood vessel using recipient’s internal iliac artery and its branches.