World journal of transplantation · 2025
Inferior epigastric artery cuff interposition for short renal artery in living-donor kidney transplantation: A case report and review of literature.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Lekehal Brahim, Ait Youssef Noura, Lekehal Mehdi, Bakkali Tarik, Jdar Asma, Bounssir Ayoub
Аннотация
BACKGROUND: Kidney transplantation is increasingly more common due to the ongoing shortage of deceased donors. However, anatomical challenges, such as a short renal artery, can complicate surgical procedures and increase complication risk, including thrombosis and anastomotic stenosis. To address these issues and optimize graft outcomes, innovative surgical techniques are essential.
CASE SUMMARY: We present a case of kidney transplantation complicated by a short donor renal artery. To address the discrepancy between arterial length and diameter mismatch, the recipient's inferior epigastric artery was used as a cuff interposition for arterial reconstruction. Following standard laparoscopic donor nephrectomy, vascular reconstruction was performed on the back table. The use of the inferior epigastric artery as a cuff allowed for successful elongation and size matching of the donor renal artery, enabling a tension-free anastomosis to the recipient's external iliac artery. Postoperative Doppler ultrasound and angiography confirmed excellent graft perfusion. The patient experienced an uneventful recovery with immediate graft function and maintained stable renal function at 6 months post-transplant. To our knowledge, this is the first reported use of the inferior epigastric artery as a cuff interposition in renal artery reconstruction, offering a novel and effective technique for managing short renal arteries in kidney transplantation.
CONCLUSION: Interposition of the epigastric artery offers an innovative technique for managing short donor renal arteries, reducing the risk of early thrombosis and long-term complications as size mismatch and intimal hyperplasia.
CASE SUMMARY: We present a case of kidney transplantation complicated by a short donor renal artery. To address the discrepancy between arterial length and diameter mismatch, the recipient's inferior epigastric artery was used as a cuff interposition for arterial reconstruction. Following standard laparoscopic donor nephrectomy, vascular reconstruction was performed on the back table. The use of the inferior epigastric artery as a cuff allowed for successful elongation and size matching of the donor renal artery, enabling a tension-free anastomosis to the recipient's external iliac artery. Postoperative Doppler ultrasound and angiography confirmed excellent graft perfusion. The patient experienced an uneventful recovery with immediate graft function and maintained stable renal function at 6 months post-transplant. To our knowledge, this is the first reported use of the inferior epigastric artery as a cuff interposition in renal artery reconstruction, offering a novel and effective technique for managing short renal arteries in kidney transplantation.
CONCLUSION: Interposition of the epigastric artery offers an innovative technique for managing short donor renal arteries, reducing the risk of early thrombosis and long-term complications as size mismatch and intimal hyperplasia.