Open Journal of Organ Transplant Surgery, 2012, 2, 5-7 Published Online May 2012 ( 5
De Novo Techniques that Facilitate the Transplant of Short
Right Allograft Kidney Vein as Left Allograft Kidney from
Live Donor
Afshar Zomorrodi, Farzad Kakaei, Shar Zomorrodi
Kidney Transplant Ward Imam Reza Hospital, Tabriz Medical Science University, Tabriz, Iran
Received December 26, 2011; revised February 13, 2012; accepted February 25, 2012
The Kidney transplant is preferred option for treatment of chronic renal failure because with this modality treatment the
life quality of patient is like normal also this modality is cost effective. The left allog raft is cho ice for tran splan t because
the short right renal vein predisposes this allograft for more complication. We introduce methods, which facilitate the
anastomosing the short right allograft vein and probably reduce the vascular complication. Methods: In 20 right al-
lograft kidneys after irrigation, with dissection between vein and artery near the hilum at the back table, placing the al-
lograft kidney with inversion position and external iliac artery selection an d first vein anastomosing and h eparin injec-
tion transplan tation is carried ou t and all the recipients are treated with three drugs (predniso lone, cyclosporine cellcept)
and follow up is conducted . Results: In these cases, with at least six months follow up , f low of the u r ine an d cir culatio n
of blood were normal. Conclusion: With regarding the results it may be concluded that with this technique it may re-
duces the vessel complication and facilitates the vessel anasto mosing of the right allograft kidney.
Keywords: Right Side Allograft; Surgical Complication; Renal Vein; Vein Thrombosis
1. Introduction
Still, the kidney transplant is the best option for the
chronic renal failure patien ts, because with this treatment
the reaching of two important goals (normal lifestyle and
cost effective) is possible. The survival of recipient and
the graft survival have been improved by the time it is
due to improving immunosuppressive and technique. The
important obstacle with kidney transplant is shortage of
the kidney donor, at challenging for the short ag ing of the
donors some centers not only accepting the deceased
donors but also they accept relative and unrelative live
donor for transplant. The success rate of the transplant
center depends on many factors, including: center de-
pending, the recipient depending and donor depending
The donor factors including: age and gender and side
of nephrectomy [2].
Many studies have done for the effect of side at the
outcome of kidney transplant, and they concluded that
there is not any different between right and left allograft
kidney, but the most importing point in these studies is
that the study is about a deceased donor and the late
complication but not about live donor and early compli-
cation [3-6]. But in the live donor, the side of nephrec-
tomy is effective in the outcome of the transplant and
early surgical complication.
At the live donor, the selection of side depends on the
function and the anatomy of kidney. First of all the kid-
ney with the best function is remained for the donor and
second if the function of two kidneys comparable the
anatomic selection is a choice.
Sometimes the right side kidney must be selected so in
that case, there is the surgical problem which depends on
the short length of a vein if it doesn’t be a good job, there
will be an early surgical problem as thrombosis of the
vein. With techniqu es that we introduce in this article the
anastomosing of the short length of the right renal vein
may be comparable with the left long renal vein.
2. Methods and Material
Twenty kidney recipients (15 males, five females since
2008) with age rang 55 - 65 in them right allograft kid-
ney has been selected for placement in the right iliac
fosse. First in the back table, the vein and the artery of
kidney carefully separated and some small connection in
the vessel of artery and vein carefully liquated this care-
ful dissection causes some increase the length of the vein.
In the recipient before clamping vessel heparin in a dose
opyright © 2012 SciRes. OJOTS
of 30 units per kilogram are injected. Right allograft
kidney placed in the right iliac fosse in the inversion po-
sition, and both the external iliac vessels (artery and vein)
are selected for anastomosing, and at first the renal vein
is anastomosed to the extern al iliac, and second the renal
artery anastomosed to external iliac artery, consequently.
Post operation all the recipients are controlled with cal-
cineurin inhibitor and cellcepts and corticosteroid.
3. Results
Post operation all the patient were followed with color
Doppler ultrasound and Para clinical evaluation, urinary
flow and blood circulation follow were normal (at least 6
months they were followed).
4. Discussions
Still the right side allograft kidney from a live related or
unrelated donor has a more complications than left-side
allograft kidney [2]. But in deceased donor study (with
using vena cava for elongation of the short vein) the re-
sults of the left and the right allograft kidney were re-
ported as comparable [3-6] but in the live donor due to
the limited vena cava the prob lem of the short renal vein
is remained and this problem predisposes the vein for
thrombosis [7,8] in our suggestion method, it can be
found easily that without inversion of the right allograft
kidney Figure 1 the renal vein is reached to the external
iliac vein under the tension and post inversion of the
right kidney allograft Figure 2 the renal vein is reached
Figure 1. Right allograft vein reaches with tension to the external iliac vein.
Figure 2. Right allograft post inversion the vein reaches to the external iliac vein without tension.
Copyright © 2012 SciRes. OJOTS
to the external iliac vein without more tension. Previ-
ously In our kidney transplant center there was a few
cases of kidney transplant that in them the allograft has
been placed in inversion position unknowingly but in
follow up they have not any urologic problem so it was
understood that inversion position from urologic stand-
point is safe. selection the external iliac artery support
the length of the renal vein because it causes the renal
vein of right allograft kidney placing directly in the front
of the external iliac vein without any deviation and first
anastomosing the renal vein support the length of renal
vein because in this condition the selection of place for
anastomosing on the external iliac vein is done freely and
unlimitedly (artery is long and free withou t leathering the
vein). Injection heparin is important in reducing throm-
4. Conclusion
Our suggestion technique facilitates the right allograft
vein anastomosing and overall it seems to reduce the
early complication of the right allograft kidney trans-
plantation it is necessary to continue these techniques
with more cases to definitive finding.
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