VASCULAR EVENTS DURING LIVE AND CADAVERIC DONOR KIDNEY TRANSPLANTATION AND SALVAGE OF GRAFT EXPERIENCE FROM 2050 RECIPIENTS

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MAHDAVI ZAFARGHANDI R.; TAVAKKOLI M.; GHOREIFI A.

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Journal Paper

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Journal: International Journal of Organ Transplantation Medicine Year:2013 | Volume:4 | Issue:3 Page(s): 130-131

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Title

VASCULAR EVENTS DURING LIVE AND CADAVERIC DONOR KIDNEY TRANSPLANTATION AND SALVAGE OF GRAFT EXPERIENCE FROM 2050 RECIPIENTS

Author(s)

MAHDAVI ZAFARGHANDI R. | TAVAKKOLI M. | GHOREIFI A.

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Abstract

Background: Vascular events during kidney transplantation is a major cause of graft loss, but immediate surgical intervention can salvage the graft and recipient.Objective: To present our experience of vascular interventions and their effects on the outcome of grafts in transplant patients with suspected vascular events.Methods: From 1990 to 2012, 2050 renal transplantations (1542 live and 408 cadaveric donors) were performed by one team. We reviewed the recipient charts to find cases with vascular events like artery or vein kinking or torsion, renal artery thrombosis (RAT) and renal vein thrombosis (RVT). A vascular event was suspected when urinary output was suddenly stopped and confirmed by color Doppler ultrasonography or immediate exploration. The kind of surgical interventions for saving grafts and their outcomes were assessed.Results: A total of 28 (1.3%) vascular accidents occurred. Arterial kinking, arterial torsion and venous torsion occurred in 9 (33%), 2 (7%) and 2 (7%) patients, respectively. RAT and RVT occurred in 12 (43%) and 3 (10%) patients, respectively. 8 of 9 arterial kinking occurred in those in whom we used internal iliac artery. The mean±SD time between anuria and surgery was 30±10, 50±10 and 65±20 min for vascular kinking, RAT, and RVT, respectively. 11 of 13 grafts with vascular kinking or torsion were saved by immediate surgical intervention, but only 4 grafts of RAT group and 1 of RVT group could be saved by surgical intervention. In RAT cases, we reopened the anastomosis and performed very small venotomy. Then we washed and perfused graft with cold heparinized ringer solution; finally, revascularization was restored. Delayed graft function occurred in all cases of saved RAT and RVT but only in 5 (40%) cases of kinking or torsion vascular cases.Conclusion: Sudden cessation of urine after renal transplantation is a warning sign and immediate diagnosis of vascular event will help salvage graft with proper intervention.

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APA: Copy

MAHDAVI ZAFARGHANDI, R., TAVAKKOLI, M., & GHOREIFI, A.. (2013). VASCULAR EVENTS DURING LIVE AND CADAVERIC DONOR KIDNEY TRANSPLANTATION AND SALVAGE OF GRAFT EXPERIENCE FROM 2050 RECIPIENTS. INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE, 4(3), 130-131. SID. https://sid.ir/paper/327461/en

Vancouver: Copy

MAHDAVI ZAFARGHANDI R., TAVAKKOLI M., GHOREIFI A.. VASCULAR EVENTS DURING LIVE AND CADAVERIC DONOR KIDNEY TRANSPLANTATION AND SALVAGE OF GRAFT EXPERIENCE FROM 2050 RECIPIENTS. INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE[Internet]. 2013;4(3):130-131. Available from: https://sid.ir/paper/327461/en

IEEE: Copy

R. MAHDAVI ZAFARGHANDI, M. TAVAKKOLI, and A. GHOREIFI, “VASCULAR EVENTS DURING LIVE AND CADAVERIC DONOR KIDNEY TRANSPLANTATION AND SALVAGE OF GRAFT EXPERIENCE FROM 2050 RECIPIENTS,” INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE, vol. 4, no. 3, pp. 130–131, 2013, [Online]. Available: https://sid.ir/paper/327461/en

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