Objective: To discuss renovascular reconstruction during living related donor kidney transplantation (LDKT).
Methods: Seventy-seven cases of LDKT from April 2006 to March 2008 were retrospectively analyzed, including 63 cases in single renal artery group and 14 cases in multiple artery group. In multiple artery group, there were 3 cases of three arteries and 11 cases of double arteries; 9 cases of donated left kidneys and 5 cases of donated right kidneys. Potential donors underwent fully medical evaluation before operation, including donor-recipient human leucocyte antigen matching and a cross match test. The donor's operation of the incision either underneath the 12th rib approaching the dorsal lumbar was performed and the transplantation operation adopted the extraperitoneal approach in the contralateral fossa iliac. The arteries in the multiple artery group were implanted onto the external (or common) iliac artery different from the orthodox method.
Results: In multiple artery group, no blood transfusion during operation was performed, no complication occurred after operation and all donors were discharged after 7-9 days of postoperation. After a follow-up of 3 months to 1 year, all the recipients kept normal kidney function without renal tubule necrosis, renal artery embolism, vascular stenosis, urinary fistula and ureter necrosis. The ultrasound examination showed that the transplanted kidney had good blood supply. There was no significant difference in the time of urine secretion, serum creatinine level after 1 week of operation, length of hospitalization between the multiple artery group and the single artery group (P > 0.05).
Conclusion: The accurate treatment of multiple artery anastomosis are critical for the safety of the LDKT.