[Angioplasty for the intimal dissection of graft artery immediately after blood reflow: a successful case of renal transplantation].
A 58-year-old woman, who had been suffering from chronic renal failure on hemodialysis since 1999, underwent living renal transplantation on January 14, 2003. The donor was her husband, and his left kidney was resected by a hand-assisted retroperitoneoscopic technique. Vascular clamps were removed after vascular anastomoses, but the color of two-thirds of the graft back side was dark, and urine excretion was not observed for 1 hour. The intimal dissection of the graft artery developed false lumen that occluded the blood flow to the transplanted kidney. The graft was resected from the recipient, and an angioplasty was performed for the false lumen of the graft artery after the second cold preservation. The graft with repaired artery was re-transplanted, and urine excretion was observed immediately after operation. Total ischemia time was 5 hours. Clinicopathological acute rejection episode and stenosis of graft artery did not occur for 6 months after operation. The intimal dissection of graft artery might occur at the time of catheterization on the perfusion for cold preservation and/or vascular anastomosis.
Saito
Mitsuru
M
Department of Urology, Akita University School of Medicine.
Satoh
Shigeru
S
Tsuchiya
Norihiko
N
Inoue
Takamitsu
T
Iinuma
Masahiro
M
Matsuura
Shinobu
S
Shimoda
Naotake
N
Ohyama
Chikara
C
Sato
Kazunari
K
Habuchi
Tomonori
T
D000714:Anastomosis, Surgical; D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery*; D017130:Angioplasty; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods; D019520:Living Donors; D008875:Middle Aged; D012077:Renal Artery / Q000601:surgery* / Q000637:transplantation; D012086:Reoperation; D015424:Reperfusion