title: Common hepatic artery as inflow in kidney transplantation.
abstract: Kidney transplantation originating from the hepatic artery has not previously been reported. Herein, we report a third kidney transplantation with the common hepatic artery as inflow. A 62-year-old male with chronic renal failure due to polycystic kidney disease was proposed to a third kidney transplantation. CT-scan showed diffuse calcification of the aorto-iliac axis and the splenic artery. The common hepatic artery was the only artery suitable for anastomosis and as such was chosen as the inflow for retransplantation. The operation was performed through a right subcostal laparotomy. A saphenous bypass was interposed between the common hepatic artery and the graft, then the renal vein was anastomosed to the suprarenal inferior vena cava. Duration of warm ischemia was 27 min. Postoperative course was complicated with delayed graft function of 17 days and pulmonary infection. Patient was discharged at day 30. With a follow-up of 40 months, serum creatinine level and eGFR are, respectively, 191 µmol/L and 32 mL/min. Hepato-renal bypass technique can be used in kidney retransplantation when patient anatomy is not compatible with other classical options.
authors.affiliation: Department of Cardiovascular Surgery, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: A
authors.initials: A
authors.lastname: Duprey
authors.affiliation: Department of Cardiovascular Surgery, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: B
authors.initials: B
authors.lastname: Chavent
authors.affiliation: Department of Nephrology and Renal Transplantation, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: N
authors.initials: N
authors.lastname: Maillard
authors.affiliation: Department of Nephrology and Renal Transplantation, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: C
authors.initials: C
authors.lastname: Mariat
authors.affiliation: Department of Nephrology and Renal Transplantation, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: E
authors.initials: E
authors.lastname: Alamartine
authors.affiliation: Department of Cardiovascular Surgery, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: J N
authors.initials: JN
authors.lastname: Albertini
authors.affiliation: Department of Cardiovascular Surgery, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Favre
authors.affiliation: Department of Cardiovascular Surgery, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: X
authors.initials: X
authors.lastname: Barral
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D007690:Polycystic Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012079:Renal Circulation / Q000502:physiology; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D012501:Saphenous Vein / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiovascular disease; retransplantation