Background.

The recovered kidney sometimes has a renal vein short in length for a satisfactory anastomosis or in some cases the vein can be damaged during the recovery procedures eventually resulting in a surgically challenging situation. Most of descripted techniques for extending the graft renal vein is allo- or auto- graft because of the concern of the possibly of infection or the risk of thrombosis caused by an artificial graft. However, many centers in Korea do not have immediate access to a cryopreserved vascular tissue. Therefore, an artificial graft is the only choice for extension of the short renal vein in most cases. Here, we report two successful cases of graft implantation using the Dacron graft (Hemagard®, Maquet, Germany). To the best of our knowledge, we present the first case to using Dacron graft.

Methods.

The short and damaged vessels in two right kidney grafts from living donors were reconstructed by interposition of Dacron grafts 2 cm in length and 10mm in diameter between a short graft renal vein and recipient's iliac vein. The grafts were not soaked in antibiotic solution before use, and systemic heparin was not given. The kidney grafts implantations were done without any intra-operative complications. After the surgery, recipients received antiplatelet drugs and they were receiving conventional immunosuppressive drugs. Doppler ultrasonography(DUS) was used to check for patency.

Results.

Both transplanted kidneys functioned well post-operatively. Cold ischemic time was relatively short less than 1hour. Excellent blood perfusion in the extended renal vein was confirmed on postoperative and follow-up kidney DUS at 6 month after the transplantation in both cases. No intra- or post-operative graft-related complications were encountered. The transplanted kidneys are in stable graft function.

Conclusions.

The Dacron graft can be a simple and feasible option for renal vein extension in kidney transplantation when limited options are available. Ultimately good kidney graft function without increased peri- or post-operative complications in both cases. The Dacron grafts are short in length with capacity for high blood flow and consequently may have good patency unlike previous artificial grafts. However, more data and long-term results are needed.

CITATION INFORMATION: Cho S., Cho W., Cho M-.J., Choi C., Ahn S., Min S-.I., Min S-.K., Kim S., Ha J. Artificial Graft Extension of Renal Vein in Living Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).

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