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31 March 2012

A novel technique for suture-free repair of renal allograft rupture

Xiu-Wu HanABCDEF, Bulang HeACDEF, Yu-Hai ZhangACDF, Buhe AminABD, Wei YanABD, Ye TianABD

DOI: 10.12659/AOT.882635

Ann Transplant 2012; 17(1): 43-49

Abstract

Background: Renal allograft rupture (RAR) is a rare complication, but it can cause graft loss and be life-threatening. Surgical exploration and repair is essential for saving the kidney graft. The aim of this article is to describe a novel suture-free technique for management of RAR.
Material/Methods: Twenty-six RARs were diagnosed in 1851 kidney transplants from November 2002 to November 2008. The study was divided into 2 groups: a suture group and a suture-free group. Twelve cases were treated in the suture group, whereas 14 were treated by the suture-free technique. In the suture-free group, absorbable thread was used to bundle the ruptured renal graft. For the suture group, autologous cubic muscular tissues or external oblique aponeurosis were used as pledgets.
Results: In the suture-free group all 14 grafts were rescued with creatinine (Cr) at 1.8±0.62 mg/dl on discharge. In the suture group all 12 grafts were repaired successfully with Cr 1.9±0.63 mg/dl on discharge. The 1-, 3- and 5-year graft survival rate was 92.8%, 82.5%, 70.50%, respectively, in the suture-free group and 84.1%, 75.5%, 67.4%, respectively, in the suture group. The suture-free technique had shorter operation time, less blood transfusion and shorter hospital stay.
Conclusions: The suture-free technique is a safe and effective technique for treatment of RAR, with advantages of shorter operating time, less blood loss and quicker recovery after surgery.

Keywords: Kidney Transplantation, complication, Graft rupture, suture-free technique

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358