Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review

<i>Background:</i> In the case of complicated kidney transplantation, when the accessory artery is severed, the main task is to decide whether to restore renal blood flow and which method should be used. In this report, we present a case of kidney transplantation with vascular reconstruc...

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Autores principales:	Saulė Bikauskaitė, Kamilė Počepavičiūtė, Linas Velička, Antanas Jankauskas, Darius Trumbeckas, Erika Šuopytė
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	kidney transplantation accessory renal artery injury arterial reconstruction ovarian vein polar artery Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/e6fc00293946451ea25b364c2ed94fd1
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spelling	oai:doaj.org-article:e6fc00293946451ea25b364c2ed94fd12021-11-25T18:18:56ZReconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review10.3390/medicina571112481648-91441010-660Xhttps://doaj.org/article/e6fc00293946451ea25b364c2ed94fd12021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1248https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background:</i> In the case of complicated kidney transplantation, when the accessory artery is severed, the main task is to decide whether to restore renal blood flow and which method should be used. In this report, we present a case of kidney transplantation with vascular reconstruction using an ovarian vein as an interposition graft between a larger branch of the main renal artery and the lower polar artery which was severed during kidney explantation. <i>Case summary:</i> Kidney transplantation using an ovarian vein was performed for a 34-year-old woman with end-stage renal disease on 1 April 2020 in the Hospital of Lithuanian university of health sciences (LUHS) Kaunas Clinics. A lower accessory renal artery was severed during kidney explantation. As the ovarian vein of the donor remained and matched the diameter of the severed vessel, it was decided to use it as an insertion between the main renal artery and the accessory renal artery of the inferior pole. The cold ischemic time was 770 min and the warm ischemic time was 37 min. A month after transplantation, the patient’s condition and daily urine output were normal and the serum creatinine level decreased rapidly. Fifteen months after the surgery, the function and structure of the transplant remained normal and there was no evidence of serious vascular complications on CT scans. This is the first case where graft function was verified after transplantation using three-dimensional CT angiography. <i>Conclusions:</i> If an inferior polar artery is severed, vascular reconstruction must be performed to preserve the function of the graft. Usually, the gonadal vein is available during donor nephrectomy; therefore, it can be explanted without additional difficulties or incisions. Although we have not reported any complications, further studies are recommended on the long-term outcomes of this alternative approach for the reconstruction of short renal arteries.Saulė BikauskaitėKamilė PočepavičiūtėLinas VeličkaAntanas JankauskasDarius TrumbeckasErika ŠuopytėMDPI AGarticlekidney transplantationaccessory renal artery injuryarterial reconstructionovarian veinpolar arteryMedicine (General)R5-920ENMedicina, Vol 57, Iss 1248, p 1248 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	kidney transplantation accessory renal artery injury arterial reconstruction ovarian vein polar artery Medicine (General) R5-920
spellingShingle	kidney transplantation accessory renal artery injury arterial reconstruction ovarian vein polar artery Medicine (General) R5-920 Saulė Bikauskaitė Kamilė Počepavičiūtė Linas Velička Antanas Jankauskas Darius Trumbeckas Erika Šuopytė Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review
description	<i>Background:</i> In the case of complicated kidney transplantation, when the accessory artery is severed, the main task is to decide whether to restore renal blood flow and which method should be used. In this report, we present a case of kidney transplantation with vascular reconstruction using an ovarian vein as an interposition graft between a larger branch of the main renal artery and the lower polar artery which was severed during kidney explantation. <i>Case summary:</i> Kidney transplantation using an ovarian vein was performed for a 34-year-old woman with end-stage renal disease on 1 April 2020 in the Hospital of Lithuanian university of health sciences (LUHS) Kaunas Clinics. A lower accessory renal artery was severed during kidney explantation. As the ovarian vein of the donor remained and matched the diameter of the severed vessel, it was decided to use it as an insertion between the main renal artery and the accessory renal artery of the inferior pole. The cold ischemic time was 770 min and the warm ischemic time was 37 min. A month after transplantation, the patient’s condition and daily urine output were normal and the serum creatinine level decreased rapidly. Fifteen months after the surgery, the function and structure of the transplant remained normal and there was no evidence of serious vascular complications on CT scans. This is the first case where graft function was verified after transplantation using three-dimensional CT angiography. <i>Conclusions:</i> If an inferior polar artery is severed, vascular reconstruction must be performed to preserve the function of the graft. Usually, the gonadal vein is available during donor nephrectomy; therefore, it can be explanted without additional difficulties or incisions. Although we have not reported any complications, further studies are recommended on the long-term outcomes of this alternative approach for the reconstruction of short renal arteries.
format	article
author	Saulė Bikauskaitė Kamilė Počepavičiūtė Linas Velička Antanas Jankauskas Darius Trumbeckas Erika Šuopytė
author_facet	Saulė Bikauskaitė Kamilė Počepavičiūtė Linas Velička Antanas Jankauskas Darius Trumbeckas Erika Šuopytė
author_sort	Saulė Bikauskaitė
title	Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review
title_short	Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review
title_full	Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review
title_fullStr	Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review
title_full_unstemmed	Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review
title_sort	reconstruction of a lower polar artery for kidney transplantation using donor ovarian vein: case report with literature review
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e6fc00293946451ea25b364c2ed94fd1
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Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review

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