[Treatment techniques of harvesting injury of donor renal blood vessels].
OBJECTIVE
To study the treatment technique for harvesting injury of donor blood vessels for the clinic application.


METHODS
The data of 32 renal transplantation patients with injury of graft blood vessels were retrospectively reviewed. 60 renal transplantation patients with non-injury during the same term were selected as the control group. The treatment techniques for harvesting injury of graft blood vessels mainly includes end-to-end anastomosis of graft artery, side-to-side anastomosis of branch artery, end-to-side anastomosis of branch artery to the main renal artery, reconstruction of multiple segmental arteries by using iliac arterial grafts from cadaveric donors or recipients on the workbench, repairs of injuries for the smaller segmental/polar arteries by using inferior epigastric artery, end-to-end anastomosis of the lower thick segmental/polar arteries with the iliac internal arterial by placing kidney upside down.


RESULTS
Those injured included 28 arterial and 4 venous. Average bench surgery time was 42 minutes. Mean warm ischemic time was 31 minutes. No death occurred at an average follow-up of 3.5 years (1 - 5 years). There was no statistical difference in the 1-year graft survival, postoperative 1-year acute rejection, delayed graft function (DGF) and the incidence of constriction of vascular anastomosis rate (96.9%, 12.5%, 21.9%, 3.1%, respectively) compared with non-reconstructed kidneys during the same term (98.3%, 11.7%, 18.3%, 1.7%, P > 0.05, respectively).


CONCLUSIONS
The flexible and appropriate application of different vascular reconstruction means and satisfactory surgery techniques play an important role in assuring quality of kidney with harvesting blood vessels injury and donor kidney availability.
Zhang
Bo
B
Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an 710033, China.
Zhang
Shao-zeng
SZ
Wang
He
H
Zhang
Geng
G
Li
Xin
X
Qin
Wei-jun
WJ
Yang
Xiao-jian
XJ
Wu
Guo-jun
GJ
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008866:Microsurgery; D009392:Nephrectomy / Q000009:adverse effects; D012077:Renal Artery / Q000293:injuries* / Q000601:surgery; D012082:Renal Veins / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D014184:Transplantation, Homologous