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Surgical Technique Notes of Arterial Vascular Reconstruction During Kidney Transplantation: Personal Experience and Literature Review
Authors:F Giovanardi  F Nudo  Q Lai  M Garofalo  A Consolo  E Choppin De Janvry  GA Arroyo Murillo  P Ursi  D Stabile  F Melandro  PB Berloco  R Pretagostini  L Poli
Institution:1. General Surgery and Organ Transplantation Unit, Department of Surgery, Sapienza University of Rome, Rome, Italy;2. Hepato-bilio-pancreatic and Liver Transplant Unit, Department of Surgery, Sapienza University of Rome, Rome, Italy
Abstract:

Background

Arterial vascular anomalies in patients undergoing kidney transplantation (KT) are correlated with a higher incidence of early surgical complications, potentially causing graft loss. Arterial reconstruction allows patients to overcome these surgical challenges, thus minimizing the risk of poor outcomes. The aim of the present study is to retrospectively investigate the safety and effectiveness of the multiple arterial reconstruction technique with a Teflon patch in case of an unavailable aortic patch: to do so, surgical complications, graft function, and patient survival were evaluated.

Methods

During the period January 2009 to August 2016, 202 adult deceased-donor KTs were performed at our center. Group A (n = 27; reconstruction of multiple arteries) and Group B (n = 175; control group) were compared.

Results

No differences were observed between the 2 groups in terms of early postoperative course, with no vascular complication observed in Group A. No vascular patch infections were reported, nor longer cold ischemia time rates. Similarly, long-term survival rates were similar between the 2 groups.

Conclusions

The Teflon-patch arterial reconstruction technique appears to be safe and effective, with an acceptable balance of benefits and potential risks of using a prosthetic material. Studies based on larger series are needed to further validate this approach.
Keywords:Address correspondence to Renzo Pretagostini  MD  General Surgery and Organ Transplantation Unit  Sapienza University of Rome  Umberto I Policlinic of Rome  Viale del Policlinico 155  00161 Rome  Italy  Tel: +39 0649970453  Fax: +39 06499701  
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