Surgical Repair of a Living-Donor Kidney Graft Artery Kink by a Postanastomotic External Iliac Artery Rotation and Reanastomosis.

Meier R; Fournier I; Toso C; Berney T; Bednarkiewicz M

doi:10.1016/j.avsg.2017.03.183

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Journal article

Surgical Repair of a Living-Donor Kidney Graft Artery Kink by a Postanastomotic External Iliac Artery Rotation and Reanastomosis.

Meier R Visceral and Transplant Surgery, Department of Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland. Electronic address: Raphael.Meier@hcuge.ch.
Fournier I Visceral and Transplant Surgery, Department of Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Toso C Visceral and Transplant Surgery, Department of Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Berney T Visceral and Transplant Surgery, Department of Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Bednarkiewicz M Visceral and Transplant Surgery, Department of Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.

2017-05-09

Published in:

Annals of vascular surgery. - 2017

Computed Tomography Angiography

English A 61-year-old man received a living-donor kidney graft for an end-stage renal disease. In the postoperative course, the patient was oliguric and needed dialysis. The postoperative Doppler showed a normal peak systolic velocity and maintained parenchymal perfusion associated with a parvus tardus signal. The patient was operated, and a kinked renal artery was found. To reposition the artery, the distal iliac artery was clamped, sectioned, shortened, and reanastomosed after a 90° axial rotation. This innovative technic allowed restoration of a normal flow in the parenchyma and avoided an additional clamping, cooling, ischemia, and reanastomosis/reperfusion of the graft. Postoperative diuresis immediately raised >100 mL/hr and creatinine durably returned to normal values.

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