The Kidney transplant is preferred option for treatment of chronic renal failure because with this modality treatment the life quality of patient is like normal also this modality is cost effective. The left allograft...The Kidney transplant is preferred option for treatment of chronic renal failure because with this modality treatment the life quality of patient is like normal also this modality is cost effective. The left allograft is choice for transplant because the short right renal vein predisposes this allograft for more complication. We introduce methods, which facilitate the anastomosing the short right allograft vein and probably reduce the vascular complication. Methods: In 20 right allograft kidneys after irrigation, with dissection between vein and artery near the hilum at the back table, placing the allograft kidney with inversion position and external iliac artery selection and first vein anastomosing and heparin injection transplantation is carried out and all the recipients are treated with three drugs (prednisolone, cyclosporine cellcept) and follow up is conducted. Results: In these cases, with at least six months follow up, flow of the urine and circulation of blood were normal. Conclusion: With regarding the results it may be concluded that with this technique it may reduces the vessel complication and facilitates the vessel anastomosing of the right allograft kidney.展开更多
BACKGROUND: In adult-to-adult living donor liver transplantation (LDLT), the use of a right lobe graft without the middle hepatic vein (MHV) can cause hepatic congestion and disturbance of venous drainage. To solve th...BACKGROUND: In adult-to-adult living donor liver transplantation (LDLT), the use of a right lobe graft without the middle hepatic vein (MHV) can cause hepatic congestion and disturbance of venous drainage. To solve this problem, we successfully used cadaveric venous allografts preserved in 4 ℃ University of Wisconsin (UW) solution within 10 days as interposition veins for drainage of the paramedian portion of the right lobe in adult LDLT. METHODS: From June 2007 to January 2008, 11 adult LDLT patients received modified right liver grafts. The major MHV tributaries (greater than 5 mm in diameter) of 9 cases were preserved and reconstructed using cadaveric interposition vein allografts that had been stored for 1 to 10 days in 4 ℃ UW solution. The regeneration of the paramedian sector of the grafts and the patency of the interposition vein allografts were examined by Doppler ultrasonography after the operation. RESULTS: MHV tributaries were reconstructed in 9 recipients. Only 1 recipient died of renal failure and severe pulmonary infection on day 9 after transplantation without any hemiliver venous outflow obstruction. The other 8 recipients achieved long-term survival with a median follow-up of 30 months. The cumulative patency rates of the 8 recipients were 63.63% (7/11), 45.45% (5/11), 45.45% (5/11) and 36.36% (4/11) at 3, 6, 12 and 24 months, respectively. Regeneration of the paramedian sectors was equivalent.CONCLUSION: The cadaveric venous allograft preserved in 4 ℃ UW solution within 10 days serves as a useful alternative for interposition veins in facilitating implantation of a right lobe graft and guarantees outflow of the MHV.展开更多
文摘The Kidney transplant is preferred option for treatment of chronic renal failure because with this modality treatment the life quality of patient is like normal also this modality is cost effective. The left allograft is choice for transplant because the short right renal vein predisposes this allograft for more complication. We introduce methods, which facilitate the anastomosing the short right allograft vein and probably reduce the vascular complication. Methods: In 20 right allograft kidneys after irrigation, with dissection between vein and artery near the hilum at the back table, placing the allograft kidney with inversion position and external iliac artery selection and first vein anastomosing and heparin injection transplantation is carried out and all the recipients are treated with three drugs (prednisolone, cyclosporine cellcept) and follow up is conducted. Results: In these cases, with at least six months follow up, flow of the urine and circulation of blood were normal. Conclusion: With regarding the results it may be concluded that with this technique it may reduces the vessel complication and facilitates the vessel anastomosing of the right allograft kidney.
文摘BACKGROUND: In adult-to-adult living donor liver transplantation (LDLT), the use of a right lobe graft without the middle hepatic vein (MHV) can cause hepatic congestion and disturbance of venous drainage. To solve this problem, we successfully used cadaveric venous allografts preserved in 4 ℃ University of Wisconsin (UW) solution within 10 days as interposition veins for drainage of the paramedian portion of the right lobe in adult LDLT. METHODS: From June 2007 to January 2008, 11 adult LDLT patients received modified right liver grafts. The major MHV tributaries (greater than 5 mm in diameter) of 9 cases were preserved and reconstructed using cadaveric interposition vein allografts that had been stored for 1 to 10 days in 4 ℃ UW solution. The regeneration of the paramedian sector of the grafts and the patency of the interposition vein allografts were examined by Doppler ultrasonography after the operation. RESULTS: MHV tributaries were reconstructed in 9 recipients. Only 1 recipient died of renal failure and severe pulmonary infection on day 9 after transplantation without any hemiliver venous outflow obstruction. The other 8 recipients achieved long-term survival with a median follow-up of 30 months. The cumulative patency rates of the 8 recipients were 63.63% (7/11), 45.45% (5/11), 45.45% (5/11) and 36.36% (4/11) at 3, 6, 12 and 24 months, respectively. Regeneration of the paramedian sectors was equivalent.CONCLUSION: The cadaveric venous allograft preserved in 4 ℃ UW solution within 10 days serves as a useful alternative for interposition veins in facilitating implantation of a right lobe graft and guarantees outflow of the MHV.
