scholarly journals Repair with Gonadal Vein Patch in the Unexpected Left Renal Vein Injury During Donor Nephrectomy

2020 ◽  
pp. 1-2
Author(s):  
Mehmet Fatih Yüzbaşioğlu ◽  
Ali İşler ◽  
Mehmet Fatih Yüzbaşioğlu ◽  
Sezgin Topuz ◽  
Alper Boz ◽  
...  

Objective: The objective of this presentation is to share our experiences with an unusual repair of a defective graft renal vein using an own gonadal vein, which occurred iatrogenically during a laparoscopic donor nephrectomy. Case Report: A 35-year-old man with situs inversus totalis was referred to our clinic for a living-related renal transplant with a diagnosis of end-stage renal disease. The donor was 66-year-old mother of the patient. Laparoscopic left donor nephrectomy was planned for his mother . At the end of laparascopic disection renal vein tear occurred during the renal extraction. Without any intervention renal extraction was performed to maintain the patency of renal allograft and to stabilize the donor. Partial hemorrhage from renal vein was brought under control. Donor nephrectomy was completed with a defective remaining segment of renal vein. We decided to repair with gonadal vein patch ın the unexpected renal vein injury. Patch from tearing part of renal vein with short gonadal vein repairment was performed. After repairment of graft renal vein, anastomosis to external iliac vein was performed. The trans-plant procedure was completed successfully. The kidney functioned immediately. Doppler ultrasound revealed that perfusion of the kidney was normal. The postoperative creatinine levels of recipient were in the normal ranges. Daily urine output was normal. Conclusion: Repairment of a defective graft renal vein by using own gonadal vein seems to be a simple, safe, and reliable method. This technique provides an alternative approach for the reconstruction of vessels in living-donor kidney transplants.

2019 ◽  
Author(s):  
S Seyfettinoglu ◽  
G Khatib ◽  
U Kucukgoz Gulec ◽  
AB Guzel ◽  
Y Bayazit ◽  
...  

2020 ◽  
Vol 54 (3) ◽  
pp. 297-300 ◽  
Author(s):  
Thomas Frederick Barge ◽  
Emma Wilton ◽  
Andrew Wigham

A 23-year-old presenting with an acute history of back pain, leg swelling, and claudication was diagnosed with an extensive iliocaval thrombosis, extending from the popliteal veins into the inferior vena cava (IVC) and left renal vein. He was treated with a combination of endovascular techniques, including EKOS and AngioJet. An underlying congenital IVC stenosis and May-Thurner type iliac vein compression were subsequently treated with venoplasty and stenting. To our knowledge, this is the first report of the use of EKOS for renal vein thrombosis and we highlight the complementary nature of different endovascular techniques for managing complex venous thrombotic disease.


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Sridhar R. Allam ◽  
Balamurugan Sankarapandian ◽  
Imran A. Memon ◽  
Patrick C. Nef ◽  
Tom S. Livingston ◽  
...  

Renal transplant vein stenosis is a rare cause of allograft dysfunction. Percutaneous stenting appears to be safe and effective treatment for this condition. A 56-year-old Caucasian female with end stage renal disease received a deceased donor renal transplant. After transplant, her serum creatinine improved to a nadir of 1.2 mg/dL. During the third posttransplant month, her serum creatinine increased to 2.2 mg/dL. Renal transplant biopsy showed BK nephropathy. Mycophenolate was discontinued. Over the next 2 months, her serum creatinine crept up to 6.2 mg/dL. BK viremia improved from 36464 copies/mL to 15398 copies/mL. A renal transplant ultrasound showed lower pole arteriovenous fistula and abnormal waveforms in the renal vein. Carbon dioxide (CO2) angiography demonstrated severe stenosis of the transplant renal vein. Successful coil occlusion of fistula was performed along with angioplasty and deployment of stent in the renal transplant vein. Serum creatinine improved to 1.5 mg/dL after.


2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Ihor Kobza ◽  
Irena Nesterenko ◽  
Volodymyr Nesterenko

The article presents the results of color Doppler ultrasonography of the left renal vein and gonadal vein with the determination of the peak systolic velocity of blood flow and abnormal blood reflux in patients with left-sided varicocele. The objective of the research was to compare preoperative ultrasound characteristics of the left renal vein, left gonadal vein, peak systolic velocity of blood flow and the presence of abnormal blood reflux, the formation of ultrasound criteria for the selection of patients for surgical correction of phlebohypertension. Results. Ultrasound signs of aorta mesenteric compression were absent in 24 (24.5%) patients; the signs of aorta mesenteric compression without critical left renal vein stenosis were observed in 64 (65.3%) patients; critical stenosis of the left renal vein was diagnosed in 10 (10.2 %) patients. The patients with critical stenosis of the left renal vein underwent left renal vein transposition. Conclusions. Ivanissevich surgery with prognostically low risk of relapse is recommended for the patients with left-sided varicocele without any signs of aorta mesenteric compression. Patients with the signs of aorta mesenteric compression require clear determination of the degree of left renal vein stenosis. We consider the transposition of the left renal vein to be indicated in case of critical stenosis when the correlation of the diameters of the distal and proximal segments of the left renal vein is ≥ 3 and the ratio of peak systolic velocities in the proximal and distal segments is ≥ 6. Thus, the diagnosis of phleborenohypertension in the patients with varicocele by means of color Doppler ultrasonography with the determination of blood flow velocity indicators in the left renal vein circulation and the determination of the critical stenosis of the left renal vein is decisive in choosing the surgical method of treatment. This provides an opportunity to evaluate the cause of varicocele occurrence and choose the optimal method of surgical treatment.  


1997 ◽  
Vol 115 (3) ◽  
pp. 1456-1459 ◽  
Author(s):  
José Carlos Costa Baptista-Silva ◽  
Marcos José Veríssimo ◽  
Marcos Joaquim Castro ◽  
André Luiz Guimarães Câmara ◽  
José Osmar Medina Pestana

The anatomical variations of renal veins observed during 342 nephrectomies in living donors are described, 311 cases on the left side and 31 on the right. The following anatomy of the renocava veins was observed: 1. On the left side the renal vein was always unique (311/311) and had two tributaries (suprarenal and gonadal veins) in 100 per cent and one or more renolumbar veins in 65.27 per cent, encircling the aorta in 1.07 per cent, was retroaortic in 1.4 per cent; and the inferior vena cava was double in 0.64 per cent; B- on the right side the renal vein was double in 29 per cent (9/31) and had only one tributary (gonadal vein) in one case, for 3.22 per cent (1/ 31); three or more renal veins in 9.7 per cent (3/31). We concluded that the left renal vein is always unique, presenting variations principally in its tributaries and trajectory. On the right side, the renal vein was double or triple in 38.79 per cent


2019 ◽  
Vol 51 (5) ◽  
pp. 1311-1313
Author(s):  
Shuichi Tatarano ◽  
Hideki Enokida ◽  
Yasutoshi Yamada ◽  
Hiroaki Nishimura ◽  
Hirofumi Yoshino ◽  
...  

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