title: Renal vein lengthening using gonadal vein reduces surgical difficulty in living-donor kidney transplantation.
abstract: BACKGROUND
  During living-donor kidney transplantation, to maximally decrease donor injury, the right kidney with lower glomerular filtration rate often is selected as the donor kidney. However, the renal vein of the right kidney is relatively short for transplantation. The gonadal vein is essentially useless and is easily accessed during the donor nephrectomy.
  
  
  METHODS
  Seventeen live kidney donors received right kidney nephrectomy for living-donor kidney transplantation. Short renal veins were lengthened by circular anastomosis or spiral anastomosis of longitudinally cut gonadal veins. The renal function of receivers was evaluated using creatinine clearance.
  
  
  RESULTS
  The renal veins were extended by 2.0-2.7 cm with circular anastomosis and 4.1-4.5 cm with spiral anastomosis with an average of 2.5 ± 0.7 cm. Lengthening of renal veins averaged 20.4 ± 4.2 min. All surgeries were successful, significantly reducing difficulty of vascular anastomosis during transplantation. No poor early graft function occurred. No side effects were observed in donors.
  
  
  CONCLUSIONS
  When donor renal veins are too short for effective kidney transplantation and may affect reliability of vascular anastomosis, they can be lengthened by using gonadal veins without increasing injury to the donor. Successful extension of donor kidney renal veins expands the indication for right donor kidneys.
authors: Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors: Jia-Yu
authors: JY
authors: Feng
authors: Chi-Bing
authors: CB
authors: Huang
authors: Ming-Qi
authors: MQ
authors: Fan
authors: Ping-Xian
authors: PX
authors: Wang
authors: Ya
authors: Y
authors: Xiao
authors: Gen-Fu
authors: GF
authors: Zhang
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D058733:Hand-Assisted Laparoscopy; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012082:Renal Veins / Q000601:surgery / Q000637:transplantation*; D014513:Ureter / Q000098:blood supply