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Renal artery reconstruction for harvesting injuries in kidney transplantation with particular reference to the use of vascular allografts.

Tzakis, AG and Mazzaferro, V and Pan, CE and Gordon, RD and Todo, S and Makowka, L and Starzl, TE (1988) Renal artery reconstruction for harvesting injuries in kidney transplantation with particular reference to the use of vascular allografts. Transpl Int, 1 (2). 80 - 85. ISSN 0934-0874

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Abstract

At the University of Pittsburgh during the calendar year 1986, an arterial injury occurred during harvesting in 20 (7.5%) of the 270 grafts used to perform kidney transplantation (KTx). Four cases required reconstruction, using extension iliac arterial allografts from cadaveric donors of the same blood type; 6 patients, remodelling of the aortic patch in multiple arteries; 4 cases, repairs for injuries to the smaller segmental/polar arteries; 6 cases, a combination of the above techniques. These ex vivo arterial reconstructions are described and the use of donor arterial homografts is emphasized. No deaths have occurred at an average follow-up of 19 months. The postoperative acute tubular necrosis (ATN) rate was significantly higher (90%) compared with non-reconstructed kidneys during the same year (30%). The 1-year graft survival of kidneys undergoing arterial reconstruction (75%) was statistically no different than the overall kidney-transplant survival. Whenever extension iliac allografts were utilized, the cyclosporin-steroid immunosuppression required to control the kidney rejection contributed to the long-term patency rate of the graft. Since the number of organs available for grafting is limited, reconstruction of injured renal vessels has become justified, allowing valuable kidneys to be used that would otherwise be lost.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Tzakis, AG
Mazzaferro, V
Pan, CE
Gordon, RD
Todo, S
Makowka, L
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: July 1988
Date Type: Publication
Journal or Publication Title: Transpl Int
Volume: 1
Number: 2
Page Range: 80 - 85
Institution: University of Pittsburgh
Refereed: Yes
Uncontrolled Keywords: Adult, Anastomosis, Surgical, Child, Humans, Kidney Transplantation, Radiography, Renal Artery
ISSN: 0934-0874
Funders: NIDDK NIH HHS (R01 DK029961-19), NIADDK NIH HHS (AM 29961)
Other ID: uls-drl:31735062130491, Starzl CV No. 899
Date Deposited: 08 Apr 2010 17:15
Last Modified: 13 Oct 2017 17:55
URI: http://d-scholarship.pitt.edu/id/eprint/4285

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