Outcomes of Kidney Transplantation by Using the Technique of Renal Artery Anastomosis First

Zi Qin Ng, Wai Lim, Bulang He

Research output: Contribution to journalArticle

Abstract

Introduction

The surgical technique for kidney transplantation has been well established: the renal vein is anastomosed first, followed by renal artery anastomosis. Alternatively, the renal artery can be anastomosed first and then the renal vein for kidney transplantation. However, there is a lack of data on the outcomes of kidney transplantation by using this alternative approach. The objective of this paper was to review the outcomes of kidney transplant by using this approach.

Methods

A review of 205 consecutive kidney transplants was conducted. All kidney transplants were performed by doing renal artery anastomosis first and then the renal vein. Data were collected, including vascular/urological complications and kidney graft function.

Results

All transplants were performed successfully with no occurrence of renal artery/vein thrombosis and urine leakage. There were five cases of renal artery stenosis that were managed with endovascular intervention. There was no recurrence on follow-up. One ureteric stenosis required surgical reconstruction.

Conclusions

This alternative vascular anastomotic technique is efficient and safe. It avoids flip-flopping the kidney graft during the vessel anastomoses and may be more practical in minimally invasive surgery for a kidney transplant due to the space constraint.

Original languageEnglish
Article numbere3223
Number of pages11
JournalCureus
Volume10
Issue number8
DOIs
Publication statusPublished - Aug 2018

Cite this

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title = "Outcomes of Kidney Transplantation by Using the Technique of Renal Artery Anastomosis First",
abstract = "IntroductionThe surgical technique for kidney transplantation has been well established: the renal vein is anastomosed first, followed by renal artery anastomosis. Alternatively, the renal artery can be anastomosed first and then the renal vein for kidney transplantation. However, there is a lack of data on the outcomes of kidney transplantation by using this alternative approach. The objective of this paper was to review the outcomes of kidney transplant by using this approach.MethodsA review of 205 consecutive kidney transplants was conducted. All kidney transplants were performed by doing renal artery anastomosis first and then the renal vein. Data were collected, including vascular/urological complications and kidney graft function.ResultsAll transplants were performed successfully with no occurrence of renal artery/vein thrombosis and urine leakage. There were five cases of renal artery stenosis that were managed with endovascular intervention. There was no recurrence on follow-up. One ureteric stenosis required surgical reconstruction.ConclusionsThis alternative vascular anastomotic technique is efficient and safe. It avoids flip-flopping the kidney graft during the vessel anastomoses and may be more practical in minimally invasive surgery for a kidney transplant due to the space constraint.",
keywords = "transplant surgery, arterial anastomosis, kidney transplant, complication, VASCULAR COMPLICATIONS, GRAFT, EXPERIENCE, MANAGEMENT, ISCHEMIA, STENOSIS, RISK",
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Outcomes of Kidney Transplantation by Using the Technique of Renal Artery Anastomosis First. / Ng, Zi Qin; Lim, Wai; He, Bulang.

In: Cureus, Vol. 10, No. 8, e3223, 08.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes of Kidney Transplantation by Using the Technique of Renal Artery Anastomosis First

AU - Ng, Zi Qin

AU - Lim, Wai

AU - He, Bulang

PY - 2018/8

Y1 - 2018/8

N2 - IntroductionThe surgical technique for kidney transplantation has been well established: the renal vein is anastomosed first, followed by renal artery anastomosis. Alternatively, the renal artery can be anastomosed first and then the renal vein for kidney transplantation. However, there is a lack of data on the outcomes of kidney transplantation by using this alternative approach. The objective of this paper was to review the outcomes of kidney transplant by using this approach.MethodsA review of 205 consecutive kidney transplants was conducted. All kidney transplants were performed by doing renal artery anastomosis first and then the renal vein. Data were collected, including vascular/urological complications and kidney graft function.ResultsAll transplants were performed successfully with no occurrence of renal artery/vein thrombosis and urine leakage. There were five cases of renal artery stenosis that were managed with endovascular intervention. There was no recurrence on follow-up. One ureteric stenosis required surgical reconstruction.ConclusionsThis alternative vascular anastomotic technique is efficient and safe. It avoids flip-flopping the kidney graft during the vessel anastomoses and may be more practical in minimally invasive surgery for a kidney transplant due to the space constraint.

AB - IntroductionThe surgical technique for kidney transplantation has been well established: the renal vein is anastomosed first, followed by renal artery anastomosis. Alternatively, the renal artery can be anastomosed first and then the renal vein for kidney transplantation. However, there is a lack of data on the outcomes of kidney transplantation by using this alternative approach. The objective of this paper was to review the outcomes of kidney transplant by using this approach.MethodsA review of 205 consecutive kidney transplants was conducted. All kidney transplants were performed by doing renal artery anastomosis first and then the renal vein. Data were collected, including vascular/urological complications and kidney graft function.ResultsAll transplants were performed successfully with no occurrence of renal artery/vein thrombosis and urine leakage. There were five cases of renal artery stenosis that were managed with endovascular intervention. There was no recurrence on follow-up. One ureteric stenosis required surgical reconstruction.ConclusionsThis alternative vascular anastomotic technique is efficient and safe. It avoids flip-flopping the kidney graft during the vessel anastomoses and may be more practical in minimally invasive surgery for a kidney transplant due to the space constraint.

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KW - arterial anastomosis

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KW - VASCULAR COMPLICATIONS

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KW - EXPERIENCE

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KW - ISCHEMIA

KW - STENOSIS

KW - RISK

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DO - 10.7759/cureus.3223

M3 - Article

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JO - Cureus

JF - Cureus

SN - 2168-8184

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