RESUMO
Renal transplantation is the best treatment for end-stage renal disease. The discrepancy between donor organ supply and demand continues to widen. Maximum efforts should be made to make use of donor kidneys and we suggest that polycystic kidneys can be suitable marginal donor organs. Five polycystic cadaveric donor kidneys were transplanted in four recipients at our institution between year 2000 and 2004. The donor kidneys were either of normal size or moderately enlarged (less than 15 x 10 cm). Donor ages were 24, 46 and 55 years. All donors had normal serum creatinine at the time of organ retrieval. Recipients gave informed consent to be transplanted with the polycystic kidneys. Three of four recipients had primary graft function. The patient with primary nonfunction required graft nephrectomy 8 weeks post-transplantation. One patient died due to cardiovascular causes with a functioning graft 18 months after transplantation. Two patients remain well, 26 and 58 months after transplantation, with normal graft function. Our experience and the limited evidence from the literature suggest that, with careful selection of both donor and recipient, transplantation of cadaveric polycystic donor kidneys should be considered given the current organ shortage.
Assuntos
Transplante de Rim/métodos , Rim , Doenças Renais Policísticas , Adulto , Cadáver , Creatinina/sangue , Humanos , Falência Renal Crônica/etiologia , Falência Renal Crônica/cirurgia , Testes de Função Renal , Pessoa de Meia-Idade , Nefrectomia , Reoperação , Doadores de TecidosRESUMO
Conduit volvulus is a very rare complication of ileal conduit. To date, only seven surgically confirmed cases have been reported. Conduit volvulus is a potentially reversible cause of renal impairment in patients with urinary diversion. The diagnosis depends on accurate radiological evaluation. The length of the bowel to construct the ileal conduit, closure of defects around the conduit and its mesentery and retroperitonealization of ureteroileal anastomosis are the determining factors for such a complication.
Assuntos
Íleo/cirurgia , Volvo Intestinal/etiologia , Derivação Urinária/efeitos adversos , Idoso , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Feminino , Humanos , Invasividade Neoplásica , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgiaRESUMO
Laparoscopic nephrectomy has lesser blood loss, quicker recovery and return to work, shorter hospital stay, lesser post operative pain and analgesia requirement associated with it compared to open nephrectomy along with having oncological equivalence to open nephrectomy for T1, T2 renal tumours and for level 1 renal vein invasion by tumour thrombus. It has assumed the status of the New Gold Standard.
