Application of homograft for intraoperative severe atherosclerotictic iliac vessel finding in renal transplantation: A case report

•Severe atherosclerosis is a complicated condition in patients with CKD and as the number of waiting list for renal transplantation rose, the rate is increasing.•Surgeons should not omit artherosclerosis even pre-operative results did not suggest it.•One-stage approach (renal transplantation and vas...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:International journal of surgery case reports 2020-01, Vol.77, p.418-421
Hauptverfasser: Le, Vu Nguyen, Pham, Lu Huu, Do, Dang Hai, Nguyen, Huong Lan, Kim Dao, Dung Thi, Nguyen, Nghia Quang
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:•Severe atherosclerosis is a complicated condition in patients with CKD and as the number of waiting list for renal transplantation rose, the rate is increasing.•Surgeons should not omit artherosclerosis even pre-operative results did not suggest it.•One-stage approach (renal transplantation and vascular reconstruction altogether) is a feasible and safe method for treating the conditions.•The role of the surgeon’s skills and experiences, and especially tissue bank should be highlighted. Severe atherosclerosis is a complicated condition in chronic kidney disease (CKD) and could lead to the operation’s failure, when it was not detectable by pre-operative diagnostic imaging. Several methods including two-stage approach, synthetic graft, stent… have been reported, but complications (i.e. infection, graft rejection) are a matter of concern. The aim of this case is to provide the one-stage approach, in which renal transplantation and vascular reconstruction using fresh homografts from one brain-dead donor were used. We reported a case of a 33-year-old male, who was diagnosed with CKD caused by chronic glomerulonephritis since the age of 28 and had been on hemodialysis. Not until did the transplantation take place that the operation team spotted the atherosclerotic external iliac artery, and vessel graft from the same donor was used and the renal was transplanted. The patient was discharged 14 days after the surgery without any complications. Kidney transplantation has revolutionized the life of patients with end-stage renal disease (ESRD). Around 6% of patients have severe atherosclerosis and the figure is increasing. Vascular degradation in ESRD might lead to unsuccessful operation. One-stage approach (including renal transplantation and external iliac artery replacement) using homograft from one doner is feasible to handle the situation. Severe atherosclerosis often accompanies with CKD. The difficulties of doing arterial anastomosis increases, which requires advanced techniques to deal with. Surgeons should be prepared about this circumstance. One-stage approach using one donor’s homografts, is a possible and safe procedure.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2020.11.022