J Korean Soc Transplant.  2009 Sep;23(2):166-168. 10.4285/jkstn.2009.23.2.166.

Kidney Transplantation after ex vivo Repair of an Aneurysm of the Donor Renal Artery

Affiliations
  • 1Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea. cmckji@catholic.ac.kr

Abstract

Kidney transplantation, particularly from a living donor, is the treatment of choice for most patients with end-stage renal disease. The superior results achieved with kidney transplantation from living donor. We report a case of transplantation using a kidney with renal arterial aneurysm from a 49-year-old living donor to her 51-year-old brother. A preoperative CT angiogram in a donor candidate showed the right kidney with 6 mm sized saccular aneurysm involves the proximal portion of anterior segmental artery. The kidney was removed by a hand-assisted laparoscopic nephrectomy. After ex vivo aneurysmectomy, the graft was transplanted into the right iliac fossa. The total ischemic time was 62 minutes, and the urine flow was started immediately after declamping. If there are multiple donor candidates of same condition, donor with unilateral renal artery aneurysm should be chosen for transplant. The use of those grafts is safe for both recipients and donors.

Keyword

Renal artery aneurysm; Kidney transplantation; ex vivo repair

MeSH Terms

Aneurysm
Arteries
Humans
Kidney
Kidney Failure, Chronic
Kidney Transplantation
Living Donors
Middle Aged
Nephrectomy
Renal Artery
Siblings
Tissue Donors
Transplants

Figure

  • Fig. 1. A resected kidney with 6 mm sized saccular aneurysm.


Reference

1). Flechner SM, Sankari B, Streem SB, Modlin CS, Serrano DP, Goldfarb DA, et al. Kidneys from living donors with renal vascular disease may be safely used for transplantation. Transplant Proc. 1997; 29:3404–5.
Article
2). Kadotani Y, Okamoto M, Akioka K, Ushigome H, Ogino S, Nobori S, et al. Renovascular reconstruction of grafts with renal artery variations in living kidney transplantation. Transplant Proc. 2005; 37:1049–51.
Article
3). Kawase T, Tanabe K, Takahashi K, Ishikawa N, Tokumoto T, Kanematsu A, et al. Ex vivo reno-vascular recon-struction in living kidney transplantation. Transplant Proc. 1998; 30:2993–4.
4). Metzger RA, Delmonico FL, Feng S, Port FK, Wynn JJ, Merion RM. Expanded criteria donors for kidney transplantation. Am J Transplant. 2003; 3(S):114–25.
Article
5). Nahas WC, Lucon AM, Mazzucchi E, Scafuri AG, Neto ED, Ianhez LE, et al. Kidney transplantation: the use of living donors with renal artery lesions. J Urol. 1998; 160:1244–7.
Article
6). Schorn B, Falk V, Dalichau H, Mohr FW. Kidney salvage in a case of ruptured renal artery aneurysm: Case report and literature review. Cardiovasc Surg. 1997; 5:134–6.
Article
7). Tham G, Ekelund L, Herrlin K, Lindstedt EL, Olin T, Bergentz SE. Renal artery aneurysms. Natural history and prognosis. Ann Surg. 1983; 197:348–52.
Article
8). Pfeiffer T, Reiher L, Grabitz K, Grunhage B, Häfele S, Voiculescu A, et al. Reconstruction for renal artery aneurysm: operative techniques and long-term results. J Vasc Surg. 2003; 37:293–300.
Article
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