髂内动脉和腹壁下动脉在肾移植供肾动脉损伤中的应用

目的探讨髂内动脉和腹壁下动脉在肾移植供肾动脉损伤中的应用。方法采用腹壁下动脉进行极动脉、副肾动脉的重建,采用髂内动脉及其分支对供肾动脉属于2、3支类型的肾脏进行血管重建。结果术后患者均未发生外科并发症。2例术后发生急性排斥反应,经用抗胸腺细胞球蛋白治疗后,血肌酐逐渐下降。1例于1个月时降至正常。1例徘徊在180.0μmol/L,3个月后恢复正常。术后随访12个月彩超显示各支动脉均通畅,移植肾血液供应丰富、均匀。结论采用髂内动脉和腹壁下动脉体外重建供肾动脉的方法,可有效修复肾动脉畸形以及肾动脉过短的供肾,是一种安全可行的血管重建的方法,血管并发症较低,可有效应用于肾移植。

Application of lliac artery and inferior epigastric artery for renal transplantation of renal artery injury

Objective To study the treatment of renal artery injury used iliac artery and inferior epigastric artery in renal transplantation.Methods Multiple arteries including artery and accessory renal artery,were repaired and reconstructed used of inferior epigastric artery.We used of internal iliac artery and its branches for the renal vascular reconstruction of the renal vascular with 2 or 3 branches.Results There were no surgical complications occurred after operation.Two patients had acute rejection,the serum creatinine decreased after treatment with anti-thymocyte globulin,one patient’s serum creatinine decreased to normal after 1 month,another patienit’s serum creatinine remained at 180.0μmol / L,and decreased to normal after 3 months.Were followed up for 12 months,ultrasound showed that patency of the artery were transplanted kidney blood supply rich,uniform.Conclusions Use of internal iliac artery and inferior epigastric artery for reconstruction of the renal artery in vitro can effectively repair the donor’s renal artery malformation and short artery.It is a safe and feasible method with low complications that vascular reconstruction and vascular complications lower,can be effectively used in kidney transplantation.