pISSN 2671-8790 eISSN 2671-8804

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Korean J Transplant 2022; 36(1): 67-72

Published online March 31, 2022

https://doi.org/10.4285/kjt.21.0027

© The Korean Society for Transplantation

The use of polytetrafluoroethylene graft for damaged renal artery in ABO-incompatible living donor kidney transplantation: a case report

Won-Bae Chang1 , Young-Heun Shin2 , Hyung Sub Park2 , Dong-Hwan Kim2 , Taeseung Lee2

1Department of Surgery, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
2Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

Correspondence to: Taeseung Lee
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173beon-gil, Bundang-gu, Seongnam 13620, Korea
Tel: +82-31-787-7092
Fax: +82-31-787-4078
E-mail: tslee@snubh.org

Received: October 15, 2021; Revised: November 17, 2021; Accepted: November 22, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Short donor renal vessels during donor nephrectomy represent a technical challenge. The allograft of vessels from deceased donors can be an option for reconstruction; however, cryopreserved vessels are not routinely prepared for living donor kidney transplantation (LDKT). We report a reconstruction of the damaged short renal artery (RA) in LDKT using a polytetrafluoroethylene (PTFE) graft. A 45-year-old male patient underwent ABO-incompatible LDKT from his wife. After donor nephrectomy, we detected a hematoma surrounding the proximal RA of the allograft. The injured segment of the RA was transected, and the short RA was connected to the right external artery of the recipient; however, the blood flow was interrupted by the graft location. Once the arterial anastomosis was removed, the graft was flushed with cold saline, and a PTFE graft was used for the reconstruction of the short RA. Immediate blood flow to the renal graft was excellent without sign of parenchymal infarction until fascial closure. Renal graft Doppler on postoperative day 7 and 3 months showed good blood flow. In this patient, the use of PTFE graft presented no additional morbidity to the kidney transplantation, and no postoperative complications related to its use were noted.

Keywords: Living donor, Kidney transplantation, Renal artery, Polytetrafluoroethylene

HIGHLIGHTS
  • Damaged or short donor renal vessels during donor nephrectomy represent a technical challenge.

  • Especially, it is more problematic in living donor kidney transplantation due to the difficulty of securing vascular graft for the reconstruction.

  • Polytetrafluoroethylene vascular graft can be used for the reconstruction of damaged renal artery.