title: A novel technique for suture-free repair of renal allograft rupture.
abstract: BACKGROUND
  Renal allograft rupture (RAR) is a rare complication, but it can cause graft loss and be life-threatening. Surgical exploration and repair is essential for saving the kidney graft. The aim of this article is to describe a novel suture-free technique for management of RAR.
  
  
  METHODS
  Twenty-six RARs were diagnosed in 1851 kidney transplants from November 2002 to November 2008. The study was divided into 2 groups: a suture group and a suture-free group. Twelve cases were treated in the suture group, whereas 14 were treated by the suture-free technique. In the suture-free group, absorbable thread was used to bundle the ruptured renal graft. For the suture group, autologous cubic muscular tissues or external oblique aponeurosis were used as pledgets.
  
  
  RESULTS
  In the suture-free group all 14 grafts were rescued with creatinine (Cr) at 1.8 ± 0.62 mg/dl on discharge. In the suture group all 12 grafts were repaired successfully with Cr 1.9 ± 0.63 mg/dl on discharge. The 1-, 3- and 5-year graft survival rate was 92.8%, 82.5%, 70.50%, respectively, in the suture-free group and 84.1%, 75.5%, 67.4%, respectively, in the suture group. The suture-free technique had shorter operation time, less blood transfusion and shorter hospital stay.
  
  
  CONCLUSIONS
  The suture-free technique is a safe and effective technique for treatment of RAR, with advantages of shorter operating time, less blood loss and quicker recovery after surgery.
authors.affiliation: Kidney Transplant Centre, Department of Urology, Beijing Shijitan Hospital Affiliate to Capital University of Medical Sciences, The Ninth Medical School of Beijing University, Beijing, P R China.
authors.forename: Xiu-Wu
authors.initials: XW
authors.lastname: Han
authors.forename: Bulang
authors.initials: B
authors.lastname: He
authors.forename: Yu-Hai
authors.initials: YH
authors.lastname: Zhang
authors.forename: Buhe
authors.initials: B
authors.lastname: Amin
authors.forename: Wei
authors.initials: W
authors.lastname: Yan
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000293:injuries* / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012421:Rupture / Q000209:etiology / Q000601:surgery; D013536:Suture Techniques; D058106:Wound Closure Techniques; D055815:Young Adult