scholarly journals Comparison between single and multiple renal vessels in live donor allograft Kidney Transplantation: Surgical Aspects and Outcomes, 25 years experience

Author(s):  
Omar Salem Khattab Alomar
Author(s):  
Jeff A Lafranca ◽  
Dennis A Hesselink ◽  
Frank J. M. F. Dor

Kidney transplantation is by far the best therapeutic option for most end-stage renal disease patients. However, there is an increased demand for donor organs worldwide, which cannot be met by the number of currently available organs. Live donation is the key to solving this problem, at least for kidneys. Besides the advantages of better patient and graft survival, short ischaemia times, and pre-emptive transplantation, live donor kidney transplantation offers many creative options to facilitate more transplants, such as paired kidney exchange programmes (or cross-over), unspecified and domino-paired donation. Due to new immunological possibilities, blood group AB0-incompatible transplantation and desensitization prior to transplantation are now a clinical reality. Over the years, the evolution of surgical techniques (from invasive towards minimally-invasive) for live donor nephrectomy has contributed tremendously to the success of the programme. This chapter gives a state-of-the-art overview of kidney donation and transplantation, with an emphasis on surgical aspects.


2018 ◽  
Vol 17 (4) ◽  
pp. e2156
Author(s):  
E. Özden ◽  
Y.K. Yakupoglu ◽  
S. Oner ◽  
M. Ozen ◽  
M. Gulsen ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitri Mikhalski ◽  
Karl Martin Wissing ◽  
Renaud Bollens ◽  
Daniel Abramowicz ◽  
Vincent Donckier ◽  
...  

Advanced atherosclerosis or thrombosis of iliac vessels can constitute an absolute contraindication for heterotopic kidney transplantation. We report the case of a 42-year-old women with end-stage renal disease due to lupus nephritis and a history of bilateral thrombosis of iliac arteries caused by antiphospholipid antibodies. Occlusion had been treated by the bilateral placement of wall stents which precluded vascular anastomosis. The patient was transplanted with a right kidney procured by laparoscopic nephrectomy from her HLA semi-identical sister. The recipient had left nephrectomy after laparoscopical transperitoneal dissection. The donor kidney was orthotopically transplanted with end-to-end anastomosis of graft vessels to native renal vessels and of the graft and native ureter. Although, the patient received full anticoagulation because of a cardiac valve and antiphospholipid antibodies, she had no postoperative complication in spite of a short period of delayed graft function. Serum creatinine levels three months after transplantation were at 1.0 mg/dl. Our case documents that orthotopical transplantation of laparoscopically procured living donor kidneys at the site of recipient nephrectomy is a feasible procedure in patients with surgical contraindication of standard heterotopic kidney transplantation.


2008 ◽  
Vol 18 (4) ◽  
pp. 263-272 ◽  
Author(s):  
Françoise G. Pradel ◽  
Puckwipa Suwannaprom ◽  
C. Daniel Mullins ◽  
John Sadler ◽  
Stephen T. Bartlett

Context Given the shortage of kidneys available for transplantation, a community-based intervention trial was implemented to assess the impact of an educational program on patients' access to live donor kidney transplantation (LDKT). Objective To compare the short-term impact of a basic intervention and an enhanced intervention on patients' readiness to pursue LDKT. Design Baseline data and data from 1 week after interventions were analyzed. Participants 214 transplant-eligible hemodialysis patients attending 14 dialysis facilities in Maryland, Virginia, and Pennsylvania. Interventions In the basic intervention, 107 patients watched a 10-minute videotape on the experience of recipients and live donors of a kidney. In the enhanced intervention, 107 patients watched the same videotape and had a discussion with a health educator on the risks and benefits of LDKT, who could be a donor, and how to address the barriers they were encountering when seeking a live kidney donor. Main outcome measure Patient reported whether they were considering LDKT, had talked with family or friends about LDKT, and had asked someone for a kidney. Results Over half of transplant-eligible patients were not pursuing LDKT at baseline (64% in the basic intervention group, 61% in the enhanced intervention group). One week after the intervention, the odds of considering LDKT were higher among African Americans (odds ratio [OR], 2.28; confidence interval [CI], 1.22–4.25), younger patients (OR, 0.94; CI, 0.91–0.97), and patients who spent less time on dialysis (OR, 0.90; CI, 0.83–0.97). The odds of asking for a kidney were higher among African Americans (OR, 4.94; CI, 2.54–9.60) and patients who perceived they were in poor to fair health (OR, 3.30; CI, 1.12–9.67). Conclusions Although both interventions helped patients consider LDKT and ask for a kidney, more time and expanded educational content might be needed to facilitate patients' discussion about LDKT with their loved ones.


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