In situ elongation patch in right kidney transplantation.
BACKGROUND
A short right renal vein complicates transplantation causing traction and difficulties during anastomosis. When we perform a kidney transplantation from a cadaveric donor, this problem may be resolved by using the vena cava to create a venous duct. This elongation technique is proposed to be performed during bench surgery. We propose a small change in the technique: execution of an "elongation patch" during harvesting and under cold perfusion.


METHODS
From January 2004 to June 2006, we performed 12 in situ (during the harvesting procedure) vena cava elongation patches. In these cases, the right renal vein was too short. The elongation patch was used in only 8 transplantations. In the other 4 cases we sacrificed the patch to perform a direct venous anastomosis due to favorable recipient anatomical characteristics.


RESULTS
The 8 transplantations performed with the elongation patch did not show vascular complications and the venous anastomosis was easy to perform.


CONCLUSIONS
The "extension patch" was not associated with a greater incidence of vascular complications. Using the elongation patch during the harvest showed some advantages: performed during cold perfusion with a reduction in bench ischemia; the anatomical relationships are preserved so we can perform a calibrated suture; the perfusion of the organ allows us to observe the integrity of the anastomosis. This technique did not significantly increase the harvesting time.
Santangelo
M
M
General, Thoracic and Vascular Surgery Department, O.U. of General Surgery and Organ Transplantation, University of Naples Federico II, Naples, Italy. michele.santangelo@unina.it
Spinosa
G
G
Grassia
S
S
Clemente
M
M
Caggiano
M
M
Pelosio
L
L
Scotti
A
A
Tammaro
V
V
Nappi
R
R
Di Capua
F
F
Renda
A
A
D000714:Anastomosis, Surgical / Q000379:methods; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology; D016030:Kidney Transplantation / Q000379:methods*; D012079:Renal Circulation; D012082:Renal Veins / Q000033:anatomy & histology* / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000033:anatomy & histology / Q000601:surgery