Rescue of kidney and pancreas grafts with complex vascular lesions.
BACKGROUND
The organ shortage mandates that grafts with complex vascular lesions be considered for graft rescue.


METHODS
Surgical graft rescue was attempted in 8 patients bearing 8 kidneys and 2 pancreata that showed complex vascular lesions deemed not suitable for interventional radiology procedures.


RESULTS
All procedures but 1 were performed under elective conditions. Seven grafts were repaired in situ, while cooling the organ through retrograde venous perfusion, and 3 kidneys were explanted, repaired extracorporeally, and retransplanted. All vascular reconstructions remain patent after a mean follow-up period of 3.3 years (+/-2.1 years).


CONCLUSIONS
Careful patient selection, multidisciplinary evaluation, and personalized surgical technique may allow the rescue of kidney and pancreas grafts with complex vascular lesions that, otherwise, would be lost.
Boggi
U
U
Divisione di Chirurgia Generale e Trapianti Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
Ferrari
M
M
Vistoli
F
F
Sgambelluri
F
F
Vignali
C
C
Cioni
R
R
Petruzzi
P
P
Del Chiaro
M
M
Berchiolli
R
R
Signori
S
S
Coletti
L
L
Gremmo
F
F
Rizzo
G
G
Mosca
F
F
D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D016035:Pancreas Transplantation / Q000009:adverse effects*; D012079:Renal Circulation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*