scholarly journals Urological and surgical complications of renal transplant recipients as a single-center experience

2020 ◽  
pp. 101-110
Author(s):  
Safa Mezban ◽  
Adnan Athafa ◽  
Ismiel Abood
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Renal Artery ◽  
Iliac Artery ◽  
Surgical Complications ◽  
Surgical Complication ◽  
External Iliac Artery ◽  
Iliac Vein ◽  
Renal Transplant Recipients ◽  
Urological Complications

Background: Kidney transplantation is considered the most effective therapy for end-stage renal disease (ESRD). Postoperative complications continue to occur in nearly 12–20% of patients. These complications can be sub-divided into three categories: vascular, urologic, and nephrogenic. Objective: To determine the surgical and urological complications of renal transplant in Basra Training Center. Patients and Methods: A prospective descriptive study was done on 71 patients who underwent renal transplant surgery between October 2015 and August 2018. After taking their informed consent, preoperative antibiotics were given, and the procedure was done under general anesthesia. In all the transplantations, the renal vein of the donor was anastomosed to the external iliac vein of the recipient with an end-to-side. While the renal artery anastomosed to the internal iliac artery of the recipient with an endto-end for the first 50 cases, in the other 21 cases, renal artery anastomosed to the external iliac artery of the recipient with an end-to-side anastomosis. Ureters were anastomosed by the Lich–Gregoire procedure. Results: Overall, urological and surgical complications were encountered in 12 of the renal transplants recipients from the total number (71, 17%). This study included a total of 71 patients (59 male and 12 female, 83% and 17%, respectively). The complications that occurred during the follow-ups of the patients were as follows: one patient developed urinary leak (1.4%), five patients developed lymphocele (7%), four patients complained of acute pyelo nephritis (6%), one patients (1.4%) complained of wound infection, and one complained of renal stone (1.4%). Conclusions: In conclusion, urological complications such as lymphocele (7%) and acute graft pyelonephritis (AGPN) (6%) remain the most common type of surgical complications following kidney transplantation (in this study). Our urological and surgical complication rate was relatively low compared to others noted in the literature. Keywords: Kidney transplantation, ESRD, urinary leak, lymphocele

Analysis of the Peak Systolic Velocity in the Transplant Renal Artery Anastomosis to Determine Normal Values in Patients Without Graft Dysfunction

2021 ◽  
pp. 875647932110298
Author(s):  
Cibele Luna ◽  
Farooq Hassan ◽  
Eduardo Scortegagna ◽  
Rosa Patricia Castillo
Keyword(s):  
Renal Artery ◽  
Iliac Artery ◽  
Peak Systolic Velocity ◽  
External Iliac Artery ◽  
Vascular Anastomosis ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Kidney Transplant Recipients ◽  
The Mean

Objective: The primary purpose is to define the mean renal artery anastomosis peak systolic velocity (RAA PSV) and the renal artery anastomosis to external iliac artery ratio (RAA-to-EIA) of renal transplant recipients without graft dysfunction. Moreover, to determine associations with type of vascular anastomosis and type of graft. Materials and Methods: This is a single-center retrospective analysis of kidney transplant recipients. Recorded variables included recipient age, type of vascular anastomosis, type of graft, RAA PSV, and external iliac artery PSV (EIA PSV). Such variables were evaluated on different postoperative follow-up periods. Results: There was a high degree of reliability between the RAA PSV and EIA PSV ( P < .001). The mean RAA PSV was 174 cm/s ± 72.9 cm/s with 95% confidence interval (CI) (162.2 cm/s-185.5 cm/s]. Conclusion: This study highlights the importance of determining the normal range of RAA PSV and showed that a high PSV does not necessarily indicate dysfunction.

scholarly journals Surgical Complications of Live Related Renal Transplantation

2016 ◽  
Vol 22 (1) ◽  
pp. 3
Author(s):  
Hafiz Shahzad Ashraf ◽  
Muhammad Seerwan ◽  
M Nasir Ibrahim ◽  
Nadir Hussain ◽  
Rana Atta-ur- Rehman
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Surgical Complications ◽  
Vascular Complications ◽  
External Iliac Artery ◽  
Renal Vein Thrombosis ◽  
Medical Institute ◽  
Ureteral Stricture ◽  
Safe Procedure ◽  
Urological Complications

AbstractIntroduction:Renal transplantation is the treatment of choice for patients with end stage renal disease. It offers marked improvement in the quality of life of patients who undergo this form of treatment. Surgical complications are important in the sense that they can lead to loss of allograft and in severe cases loss of patient life. The aim of this study is to determine the frequency of surgical complications after renal trans-plantation in our population.Materials and Methods:We retrospectively reviewed the surgical complications in 350 patients who had live related renal transplantation performed at Postgraduate Medical Institute, Shaikh Zayed hospital Lahore from January 2007 to December 2013.Results:Among 57 (16.1%) surgical complications 18 (5.1%) had urological complications. Urinary fistulae, ureteral stenosis, ureteral stricture and hematuria occurred in 9 (2.5%), 4 (1.14%), 4 (1.14%) and 1 (0.28%) patients respectively. Vascular complications occurred in 5 (1.42%) patients in total. 2 (0.57%) patients had renal artery thrombosis and 1 (0.28%) patient had renal vein thrombosis. 2 (0.57%) patients had thrombosis of external iliac artery. Lymphocele occur-red in17 (4.8%) of patients and wound infection developed in 19 (5.4%) patients.Conclusion:Surgical complications after kidney transplantation may be reduced or minimized if basic surgical principles of transplantation are followed. We conclude that kidney transplantation is a safe procedure with fewer surgical complications. The most important thing is the early diagnosis and prompt treatment of the complications in order to save the graft and the patient.Keywords:Transplantation, Complications, Live related.

scholarly journals Different techniques of vessel reconstruction during kidney transplantation

2015 ◽  
Vol 72 (7) ◽  
pp. 614-618 ◽  
Author(s):  
Aleksandar Tomic ◽  
Novak Milovic ◽  
Ivan Marjanovic ◽  
Zoran Bjelanovic ◽  
Ivan Lekovic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Artery ◽  
Iliac Artery ◽  
Standard Procedure ◽  
External Iliac Artery ◽  
Renal Arteries ◽  
Ptfe Graft ◽  
Renal Artery Reconstruction ◽  
Kidney Transplantations ◽  
Vessel Reconstruction

Background/Aim. Multiple renal arteries (MRAs) represent a surgical challenge by the difficulty in performing anastomoses, bleeding and stenosis. MRAs should be preserved and special attention should be paid to accessory polar arteries. All renal arteries (RAs) must be reconstructed and prepared for safe anastomosis. The paper decribed the different techniques of vessel reconstruction during kidney transplantation including important steps within recovery of organs, preparation and implantation. Methods. In a 16-year period (1996-2012) of kidney transplantation in the Military Medical Academy, Belgrade, a total of 310 living donors and 44 human cadaver kidney transplantations were performed, of which 28 (8%) kidneys had two or more RAs. Results. All the transplanted kidneys had immediate function. We repaired 20 cases of donor kidneys with 2 arteries, 4 cases with three RAs, one case with 4 RAs, one case with 4 RAs and renal vein reconstruction, one case with 3 arteries and additional polytetrafluoroethylene (PTFE) graft reconstruction, one case with transected renal artery and reconstruction with 5 cm long deceased donor external iliac artery. There were no major complications and graft failure. At a minimum of 1-year follow-up, all the patients showed normal renal function. Conclusion. Donor kidney transplantation on a contralateral side and ?end-to-end? anastomosis of the renal artery to the internal iliac artery (IIA) is our standard procedure with satisfactory results. Renal artery reconstruction and anastomosis with IIA is a safe and highly efficient procedure and kidneys with MRAs are not contraindicated for transplantation. A surgical team should be fully competent to remove cadaveric abdominal organs to avoid accidental injuries of organs vessels.

Renal Artery Stenosis in Hypertensive Renal Transplant Recipients

1977 ◽  
Vol 118 (2) ◽  
pp. 240-243 ◽  
Author(s):  
Olof Lindfors ◽  
Leena Laasonen ◽  
Frej Fyhrquist ◽  
Boris Kock ◽  
Björn Lindström
Keyword(s):  
Renal Transplant ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

scholarly journals Anatomical variation of obturator vessels and its practical risk: a case report from an anatomic study

2008 ◽  
Vol 7 (3) ◽  
pp. 275-277 ◽  
Author(s):  
Somayaji Nagabhooshana ◽  
Venkata Ramana Vollala ◽  
Vincent Rodrigues ◽  
Seetharama Bhat ◽  
Narendra Pamidi ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Anatomical Variation ◽  
External Iliac Artery ◽  
Iliac Vein ◽  
Inferior Epigastric Artery ◽  
Undergraduate Medical Students ◽  
Obturator Artery ◽  
External Iliac Vein ◽  
Epigastric Artery ◽  
Internal Iliac

Obturator artery is frequently a branch of anterior division of the internal iliac artery. It has drawn attention of pelvic surgeons, anatomists and radiologists because of the high frequency of variations in its course and origin. The obturator vein is usually described as a tributary of the internal iliac vein. During routine dissection classes to undergraduate medical students we have observed obturator artery arising from external iliac artery, obturator vein draining into external iliac vein, communicating vein between obturator vein and external iliac vein and inferior epigastric artery arising from the obturator artery. The anomalous obturator vessels and inferior epigastric artery in the present case may be in a dangerous situation in pelvic surgeries that require dissection or suturing along the pelvic rim. Developmental reasons and clinical significances of the variations are discussed.

scholarly journals Immunosenescence as a reason of individualizing immunosuppressive therapy in kidney transplantation

2021 ◽  
Vol 23 (3) ◽  
pp. 171-179
Author(s):  
V. A. Fedulkina ◽  
A. V. Vatazin ◽  
A. V. Kildyushevskiy ◽  
A. B. Zulkarnayev ◽  
D. V. Gubina ◽  
...  
Keyword(s):  
Innate Immunity ◽  
Kidney Transplantation ◽  
Renal Transplant ◽  
Immunosuppressive Therapy ◽  
Immunosuppressive Drugs ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Optimal Balance ◽  
Underlying Diseases ◽  
Adaptive And Innate Immunity

Transplantation in elderly patients is obviously more challenging due to existing underlying diseases, changes in pharmacokinetics of immunosuppressive drugs, polypragmasy, and transformation of immunoreactivity (immunosenescence). Our review presents data on modification of adaptive and innate immunity during aging. It also considers the possibility of both reduced and adapted immunosuppressive therapy in elderly renal transplant recipients in achieving an optimal balance between efficacy and complications.

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