June 1974

Vascular Surgical Problems in Renal Transplantation

Author Affiliations

St. Louis
From the departments of surgery, St. Louis University (Drs. Codd and Gregory) and Washington University (Drs. Anderson, Lucas, and Newton) medical schools, Jewish Hospital (Dr. Graff), and St. Louis Veterans Administration Hospital, St. Louis.

Arch Surg. 1974;108(6):876-878. doi:10.1001/archsurg.1974.01350300106026

Vascular manipulations that differed from the standard technique of renal transplantation were required in 40 of 107 human renal transplantations (38%). Double renal arteries were managed successfully by a side-to-side arterioplasty to form a single common lumen in nine instances. Polar infarcts occurred in seven of eight cases requiring ligation of polar arteries. Double renal veins were probably handled by ligating one of the veins because of the extensive intrarenal venous communication. Endarterectomy of the recipient's iliac system was required in ten transplants because of extensive atherosclerosis. It is concluded that the frequency of vascular abnormalities encountered in renal transplantation requires that the transplant surgeon be familiar with a variety of vascular surgical techniques.