Type of vascular anastomosis and early outcome after kidney transplantation


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

There are usually two main techniques of vessel anastomosis called as; end-to-end or end-to-side. The aim of this study was to investigate surgical vascular anastomotic and its’ correlation with early outcome after kidney transplantation. Data including gender, age, hospital stay, living or deceased donor, evidence of acute tubular necrosis, preference of artery or vein in addition to biochemical variables were noted analysed by SPSS. The study population was comprised of 84 females and 176 males (174 living versus 86 deceased donor). Surgical vascular anastomic techniques were based on; first artery second vein (FASV; n=209) or first vein second artery (FVSA; n=51). Vascular anastomic were performed as follow; group 1 (FASV with end-to-end; n= 52%), group 2 (FASVwith end-to-side; n=29%), group 3 (FVSA with end-to-end; n=15%) and group 4 (FVSA with end-to-side; n= 5%). Comparison of groups showed that; deceased/living donor (group 1 versus group 3; p=0.02), ATN (group 1 versus group 2; p=0.002, group 1 versus group 4; p=0.03). Despite the higher use of deceased donors, those with vascular anastomic technique based on FASV (end-to-end) revealed a lower rate of ATN when compared to other techniques. Further studies in this direction recommended.

Full Text

Restricted Access

About the authors

Farhad Tadayon

Isfahan University of Medical Sciences

Ali Shariati

Isfahan University of Medical Sciences

Zahra Tolou_Ghamari

Isfahan University of Medical Sciences

Deputy of Research and Technology, Metabolic Liver Disease Research Center

References

  1. Bicalho PR, Requiao-Moura LR, Arruda EF, Chinen R, Mello L, Bertocchi APF, Lamkowski Naka E, Tonato EJ, Pacheco-Silva A. Long-Term Outcomes among Kidney transplant Recipients and after Graft Failure: A Single-Center Cohort Study in Brazil. Biomed Res Int. 2019 Apr 2;2019:7105084. doi: 10.1155/2019/7105084. eCollection 2019.
  2. Kuss R, Teinturier J, Milliez P. [Some attempts at kidney transplantation in man].Mem Acad Chir (Paris) 1951; 77: 755.
  3. Matheus WE, Reis LO, Ferreira U, Mazzali M, Denardi F, Leitao VA, Pedro RN, Netto NR Jr. Kidney transplant anastomosis: internal or external iliac artery? Urol J. 2009 Fall;6(4):260-6.
  4. Sutherland RS, Spees EK, Jones JW, Fink DW. Renal artery stenosis after renal transplantation: the impact of the hypogastric artery anastomosis. J Urol. 1993 May;149(5):980-5.
  5. Ng ZQ, Lim W, He B. Outcomes of Kidney Transplantation by Using the Technique of Renal ArteryAnastomosis First. Cureus. 2018 Aug 28;10(8):e3223. doi: 10.7759/cureus.3223.
  6. Marzouk K, Lawen J, Alwayn I, Kiberd BA. The impact of vascular anastomosis time on early kidney transplant outcomes.Transplant Res. 2013;2:8.
  7. Merrill JP, Murray JE, Harrison JH, Guild WR. Successful homotransplantation of the human kidney between identical twins. J Am Med Assoc. 1956;160:277-282.
  8. Bessede T, Droupy S, Hammoudi Y, Bedretdinova D, Durrbach A, Charpentier B, Benoit G. Surgical prevention and management of vascular complications of kidney transplantation. Transpl Int. 2012;25:994-1001.
  9. Kerr KF, Morenz ER, Thiessen-Philbrook H, Coca SG, Wilson FP, Reese PP, Parikh CR. Quantifying Donor Effects on Transplant Outcomes Using Kidney Pairs from Deceased Donors. Clin J Am Soc Nephrol. 2019 Nov 1. pii: CJN.03810319. doi: 10.2215/CJN.03810319.
  10. Tafulo S, Malheiro J, Santos S, Dias L, Almeida M, Martins S, Pedroso S, Mendes C, Lobato L, Castro-Henriques A. Degree of HLA class II eplet mismatch load improves prediction of antibody-mediated rejection in living donor kidney transplantation. Hum Immunol. 2019 Oct 8. pii: S0198-8859(19)30995-4. doi: 10.1016/j.humim
  11. Tolou-Ghamari Z, Palizban AA, Michael Tredger J. Clinical monitoring of tacrolimus after liver transplantation using pentamer formation assay and microparticle enzyme immunoassay.Drugs R D. 2004;5(1):17-22.
  12. Tolou-Ghamari Z, Palizban AA. Kidney transplant recipients and the incidence of adverse reactions to cyclosporin.Saudi Med J. 2004 Oct;25(10):1499-500.
  13. Tolou-Ghamari Z, Mortazavi M, Palizban AA, Najafi MR. The investigation of correlation between Iminoral concentration and neurotoxic levels after kidney transplantation. Adv Biomed Res. 2015 Feb 23;4:59.
  14. Malheiro J, Santos S, Tafulo S, Dias L, Martins S, Fonseca I, Almeida M, Pedroso S, Beirao I, Castro-Henriques A, Cabrita A. Detection of Complement-binding Donor-specific Antibodies, Not IgG-antibody Strength Nor C4d Status, at Antibody-mediated Rejection Diagnosis Is an Independent Predictor of Kidney Graft Failure. Transplantation. 2018 Nov;102(11):1943-1954. doi: 10.1097/TP.0000000000002265.
  15. Malheiro J, Santos S, Tafulo S, Dias L, Martins S, Fonseca I, Almeida M, Pedroso S, Beirao I, Castro-Henriques A, Cabrita A. Correlations between donor-specific antibodies and non-adherence with chronic active antibody-mediated rejection phenotypes and their impact on kidney graft survival. Hum Immunol. 2018 Jun;79(6):413-423. doi: 10.1016/j. humimm.2018.03.004. Epub 2018 Mar 22.
  16. Malheiro J, Tafulo S, Dias L, Martins S, Fonseca I, Beirao I, Castro-Henriques A, Cabrita A. Deleterious effect of anti-angiotensin II type 1 receptor antibodies detected pretransplant on kidney graft outcomes is both proper and synergistic with donor-specific anti-HLA antibodies. Nephrology (Carlton). 2019 Mar;24(3):347-356. doi: 10.1111/nep.13239.
  17. Naik AS, Zhong Y, Parasuraman R, Doshi M, Norman S, Lu Y, Shaban E, Shahinian V, Schaubel DE. The temporal and long-term impact of donor body mass index on recipientoutcomes after kidney transplantation - a retrospective study. Transpl Int. 2019 Sep 3. doi: 10.1111/tri.13505.
  18. Stratta RJ, Rohr SM, Sundberg AK, Armstrong G, Hairston G, Hartmann E, et al. Increased Kidney Transplantation Utilizing Expanded Criteria Deceased Organ Donors with Results Comparable to Standard Criteria Donor Transplant. Ann Surg. 2004 May; 239(5): 688-697.
  19. Negi S, Koreeda D, Kobayashi S, Yano T, Tatsuta K, Mima T, Shigematsu T, Ohya M. Acute kidney injury: Epidemiology, outcomes, complications, and therapeutic strategies. Semin Dial. 2018 Sep;31(5):519-527.
  20. Daowd R, Al Ahmad A. Renal artery anastomosis to internal or external iliac artery in kidney transplant patients. Saudi J Kidney Dis Transpl. 2015 Sep;26(5):1009-12.
  21. Tadayon F, Shariati A, Tolou-Ghamari Z. Study of 2550 donor-recipient demographic characteristics associated with kidney transplantation in Isfahan Province, Iran. AJECR. 2018; 5 (4).
  22. Huang E, Segev DLM, Rabb H. Kidney Transplantation in the Elderly. Semin Nephrol. 2009 Nov; 29(6): 621-635.
  23. McAdams-DeMarco MA, King EA, Luo X, Haugen C, DiBrito S, Shaffer A, Kucirka LM, Desai NM, Dagher NN, Lonze BE, Montgomery RA Walston J, Segev DL. Frailty, Length of Stay, and Mortality in Kidney Transplant Recipients: A National Registry and Prospective Cohort Study. Ann Surg. Ann Surg. 2017 Dec; 266(6): 1084-1090.
  24. O’Neill S, Oniscu GC, Harrison EM. Faster may be better for anastomosis time, but does it really affect survival? Transpl Int 2015; 28: 764.
  25. Salvadori M, Tsalouchos A. Histological and clinical evaluation of marginal donor kidneys before transplantation: Which is best? World J Transplant. 2019 Aug 26; 9(4): 62-80.
  26. Dilip Kumar Pal, Prakash Kumar Sanki, Sayak Roy. Analysis of outcome of end-to-end and end-to-side internal iliac artery anastomosis in renal transplantation: Our initial experience with a case series. Urol Ann. 2017 Apr-Jun; 9(2): 166-169.
  27. Moon I, Kim Y, Park J, Kim S, Koh Y. Various vascular procedures in kidney transplantations. Transplant Proc 1998;30:3006.
  28. Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients: (SRTR). OPTN/SRTR 2011 Annual Data Report, Rockville, MD, Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, 2012.
  29. Kim JK, Lorenzo AJ, Farhat WA, Chua ME, Ming JM, Santos JD, Koyle MA. A comparison of post-transplant renal function in pre-emptive and post-dialysis pediatric kidney transplant recipients. 2019; 23 (23); Pediatric Transplanation.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies