Vascular inflow after renal transplantation: Does the arteriotomy technique impact early allograft perfusion and function?
Pediatr Transplant
; 24(8): e13814, 2020 12.
Article
em En
| MEDLINE
| ID: mdl-32840044
ABSTRACT
BACKGROUND:
There are two main techniques for arterial reconstruction in RT TA using a stab longitudinal incision which creates an elliptical opening and AP which fashions a circular defect. We hypothesized that AP creates a natural anastomosis lumen, similar to the donor renal artery, which optimizes RT perfusion.METHODS:
A retrospective review of a single-institution database was performed between 2000 and 2018. Twenty patients who underwent AP arteriotomy were compared to 40 TA-matched controls. Data were collected on creatinine (preoperative, nadir, and time to nadir), and DUS RI and PSV at 1 week, 3 months, and 6-12 months post-RT.RESULTS:
ttNC was shorter in the AP group (5 ± 4 vs 12 ± 13 days; P = .03). PSV at 1 week was lower in the AP group (186 ± 65 cm/s vs 232 ± 89 cm/s; P = .04). There was no difference in nadir creatinine value (P = .26), preoperative creatinine (P = .66), and initial postoperative creatinine (P = .80). RI at week 1 were not different between groups (P = .37). Follow-up DUS showed the difference in PSV between groups became non-significant (1 month P = .50 and 6-12 months P = .53).CONCLUSIONS:
AP arteriotomy in RT improves early perfusion and function parameters (ttNC and initial PSV) as compared to TA. AP arteriotomy optimizes early allograft reperfusion, which may have important long-term implications and deserves further evaluation.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Artéria Renal
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Procedimentos Cirúrgicos Vasculares
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Transplante de Rim
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Rim
Tipo de estudo:
Observational_studies
Limite:
Child
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article