[Methods of extracorporeal renal artery reconstruction in cadaveric kidney allografts with special reference to...

In this paper our experiences with extracorporeal microsurgical repair and transplantation of kidneys with injured accessory renal arteries are described. We present our effort to increase the number of suitable donor kidneys for transplantation. Three extracorporeal reconstructive techniques are used that are applicable to most of the vascular injuries presented by multiple renal arteries: End-to-side-anastomosis between the polar and the main artery. Side-to-side-anastomosis of two arteries with the same diameter. Use of autologous vascular grafts, e.g. inferior epigastric artery. 13 allografts underwent ex vivo microsurgical repair of injured polar arteries prior to allotransplantation and 1 patient had an in situ repair. There was no operative complication and only one late arterial stenosis occur, seven transplants currently are functioning. Our clinical experience with ex vivo microsurgical repair has been favourable. The increasing number of transplantable cadaver donor kidneys and the decreasing incidence of urinary fistulas supports their continued application in appropriate situations.