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. 2023 Feb 10:36:11060.
doi: 10.3389/ti.2023.11060. eCollection 2023.

Renal Vessel Extension With Cryopreserved Vascular Grafts: Overcoming Surgical Pitfalls in Living Donor Kidney Transplant

Guido Fallani  1 , Lorenzo Maroni  1 , Chiara Bonatti  1 , Giorgia Comai  2 , Marina Buzzi  3 , Vania Cuna  2 , Francesco Vasuri  4 , Francesca Caputo  1 , Enrico Prosperi  1 , Federico Pisani  1 , Beatrice Pisillo  1 , Ludovica Maurino  1 , Federica Odaldi  1 , Valentina Rosa Bertuzzo  1 , Francesco Tondolo  2 , Marco Busutti  2 , Chiara Zanfi  1 , Massimo Del Gaudio  1 , Gaetano La Manna  2   5 , Matteo Ravaioli  1   6
Affiliations

Renal Vessel Extension With Cryopreserved Vascular Grafts: Overcoming Surgical Pitfalls in Living Donor Kidney Transplant

Guido Fallani et al. Transpl Int. .

Abstract

In LDKT, right kidneys and kidneys with anomalous vascularization are often deferred because of concerns on complications and vascular reconstructions. To date, only few reports have examined renal vessel extension with cryopreserved vascular grafts in LDKT. The aim of this study is to investigate the effect of renal vessel extension on short-term outcomes and ischemia times in LDKT. From 2012 to 2020, recipients of LDKT with renal vessels extension were compared with standard LDKT recipients. Subset analysis of rights grafts and grafts with anomalous vascularization, with or without renal vessel extension, was performed. Recipients of LDKT with (n = 54) and without (n = 91) vascular extension experienced similar hospital stays, surgical complications and DGF rates. For grafts with multiple vessels, renal vessel extension granted a faster implantation time (44±5 vs. 72±14 min), which resulted comparable to that of standard anatomy grafts. Right kidney grafts with vascular extension had a faster implantation time compared to right kidney grafts without vascular lengthening (43±5 vs. 58±9 min), and a comparable implantation time to left kidney grafts. Renal vessel extension with cryopreserved vascular grafts allows faster implantation time in right kidney grafts or grafts with anomalous vascularization, maintaining similar surgical and functional outcomes.

Keywords: abnormal kidney vascularization; cryopreserved vascular allografts; living donor kidney transplant; renal vessel extension; right kidney donation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Graft survival in kidney transplants with and without renal vessel extension.
FIGURE 2
FIGURE 2
Reconstruction of multiple arteries with a single cryopreserved vascular graft: bench surgery (A) and reimplantation (B).
FIGURE 3
FIGURE 3
Extension of right renal vein through cryopreserved vascular graft.
See this image and copyright information in PMC

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