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Efficacy of lengthening right renal veins using accompanying gonadal veins in living donor kidney transplantation

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Abstract

Background

Short harvested right renal veins (RV) are quite common in living donor kidney transplantation (KT). This technical difficulty might interfere implanting and increase warm ischemic time. Several techniques to overcome this problem have been applied, including iliac vein transposition, inverted transplant, synthetic graft, saphenous vein… Application of accompanying gonadal vein (GV), which is easily approachable and less time-consuming, has been recently published. This study aims to evaluate its effectiveness and safety.

Methods

Retrospective study on KT using the gonadal vein to lengthen the short right renal vein at Viet Duc University Hospital from April 2019 to April 2022. The following data were gathered: baseline characteristics, vascular imaging in CT scan/after nephrectomy and after reconstruction (mm), reconstruction and surgical time, hospitalization days. The outcomes were determined by kidney function after transplantation (plasma creatinine, creatinine clearance) and related complications.

Results

Twenty-five cases with procured right kidney with short RV from the living donor which were reconstructed and lengthened by the accompanying GV were collected. The additional length of RV was 15.9 ± 2.4 mm. Average cold ischemic time, venoplasty time, warm ischemic time were 60.4 ± 8.2, 21.2 ± 5.3, and 38.1 ± 5.6 min, respectively. The average hospital stay was 15.3 ± 3.2 days. Average follow-up time was 31 ± 5.2 months, creatinine clearance was around 60 ml/min after 1 year, no vascular or urologic complications was observed.

Conclusion

Accompanying GV from a living donor to lengthen short right RV in KT is a feasible, safe, and effective technique.

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Data availability

All data generated or analyzed during this study are included in this published article.

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Funding

The authors declare no funding for this study.

Author information

Authors and Affiliations

  1. Organ Transplantation Center, Viet Duc University Hospital, Hanoi, Vietnam

    Khai Ninh Viet, Tuan Hoang, Dang Do Hai, Dung Tran Dinh & Vu Le Nguyen

  2. HNUE High school for gifted students, Hanoi, Vietnam

    Ngoc Ninh Bao

  3. Cardiovascular and Thoracic Center, Viet Duc University Hospital, Hanoi, Vietnam

    Hung Duong Duc

Authors
  1. Khai Ninh Viet
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  2. Tuan Hoang
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  3. Dang Do Hai
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  4. Dung Tran Dinh
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  5. Ngoc Ninh Bao
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  6. Vu Le Nguyen
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  7. Hung Duong Duc
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Contributions

Khai NV: Do the operation, design the research, write the manuscript; Tuan H: Do the operation, write the manuscript; Dang DH: design the research, write the manuscript; Dung TD: Do the operation, collect the data; Ngoc NB: Analyze the data THL; Vu LN: design the research, write and revise the manuscript, Hung DD: write and revise the manuscript. All authors have discussed the results together and contributed to the final manuscript.

Corresponding author

Correspondence to Dang Do Hai.

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Ethics approval and consent to participate

Ethics approval of this study was given by the Institutional Ethical Review Board. Written informed consent for publication of their clinical details and clinical images was obtained from the patients’ family.

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Not commissioned, externally peer reviewed.

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The authors declare that they have no conflicts of interest.

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Viet, K.N., Hoang, T., Hai, D.D. et al. Efficacy of lengthening right renal veins using accompanying gonadal veins in living donor kidney transplantation. World J Urol 42, 407 (2024). https://doi.org/10.1007/s00345-024-05094-y

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