Microvascular surgery in experimental and clinical kidney transplantation
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An improved microsurgical technique for orthotopic rat kidney transplantation is described in detail. (1) End-to-end anastomosis of renal arteries with 7–8 interrupted 10-0 sutures. (2) End-to-end anastomosis of renal veins with 2 continuous semicircular 10-0 sutures. (3) Non-splinted end-to-end ureteric anastomosis with 4 interrupted full-thickness 11-0 sutures. (4) Simultaneous bilateral nephrectomy. Seventy transplantations were analysed. No failure due to complications of the vascular anastomoses occurred. The ureteric anastomoses were complicated by stenosis in only 5 animals (7%). The operation times for vascular anastomoses were 20 (15–24) minutes and for complete transplantation 50 (45–60) minutes. This technique seems to be less time consuming than other methods. Our method has produced a success rate of 93% with well standardized and reproducible organ quality.
Preliminary clinical experiences with extracorporeal microvascular reconstruction in 4 cases of injured small polar kidney allograft arteries support the continued application in appropriate situations to increase the number of suitable donor kidneys.
KeywordsRenal Artery Kidney Transplantation Renal Vein Donor Kidney Organ Quality
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