Xuhui Zhu1,2, Yongwei Zhao3,4, Xiuwu Han5,6, Yansheng Li1,2, Peng Zhang1,2, Siyuan Wang1,2, Gao Li1,2, Chunhong Xiang7. 1. Institute of Urology, Capital Medical University, Beijing, People's Republic of China. 2. Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China. 3. Department of Urology, Taian City Central Hospital, Taian, 271000, Shangdong, People's Republic of China. 4. School of Clinical Medicine, Tsinghua University, Beijing, 100084, People's Republic of China. 5. Institute of Urology, Capital Medical University, Beijing, People's Republic of China. hanxiuwu47859@163.com. 6. Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China. hanxiuwu47859@163.com. 7. Department of Surgery and Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, People's Republic of China.
Abstract
OBJECTIVE: To report on the pioneering clinical experiences of six cases of extraperitoneal laparoscopic kidney transplantation in China. METHODS: For the first time in clinical practice, a customised, controllable double-circulation cooling device was used to protect the transplanted kidney. Of the six patients, two underwent an allograft renal transplantation because they had been diagnosed with uraemia and were on maintenance haemodialysis. The other four patients underwent kidney autotransplantation because of a central renal tumour. RESULTS: The extraperitoneal laparoscopic kidney transplantations were successfully completed between 2017 and 2018. The operative time for the two patients undergoing the allograft transplantation was 3-3.5 h. The time for venous anastomosis was approximately 53-65 min, and the time for arterial anastomosis was approximately 25-30 min. The creatinine level was 90-80 μmol/L after surgery. The operative time of the four patients who underwent autotransplantation was 9.4-17.5 h. The times of venous and arterial anastomosis were 58-90 min and 35-48 min, respectively. The follow-up B-mode ultrasound after surgery showed good blood supply in the spared nephron. A renal graft was removed from one patient 6 months after surgery because of renal atrophy and dysfunction caused by poor blood supply. Five patients (two undergoing allografting and three undergoing autografting) completed the 12-month follow-up, and their renal graft function was good. CONCLUSIONS: Extraperitoneal laparoscopic kidney transplantation, either allograft or autologous transplantation, is a safe and feasible procedure with a good chance of survival for the transplanted kidney. A customised cooling device is effective and practical during laparoscopic kidney transplantation.
OBJECTIVE: To report on the pioneering clinical experiences of six cases of extraperitoneal laparoscopic kidney transplantation in China. METHODS: For the first time in clinical practice, a customised, controllable double-circulation cooling device was used to protect the transplanted kidney. Of the six patients, two underwent an allograft renal transplantation because they had been diagnosed with uraemia and were on maintenance haemodialysis. The other four patients underwent kidney autotransplantation because of a central renal tumour. RESULTS: The extraperitoneal laparoscopic kidney transplantations were successfully completed between 2017 and 2018. The operative time for the two patients undergoing the allograft transplantation was 3-3.5 h. The time for venous anastomosis was approximately 53-65 min, and the time for arterial anastomosis was approximately 25-30 min. The creatinine level was 90-80 μmol/L after surgery. The operative time of the four patients who underwent autotransplantation was 9.4-17.5 h. The times of venous and arterial anastomosis were 58-90 min and 35-48 min, respectively. The follow-up B-mode ultrasound after surgery showed good blood supply in the spared nephron. A renal graft was removed from one patient 6 months after surgery because of renal atrophy and dysfunction caused by poor blood supply. Five patients (two undergoing allografting and three undergoing autografting) completed the 12-month follow-up, and their renal graft function was good. CONCLUSIONS: Extraperitoneal laparoscopic kidney transplantation, either allograft or autologous transplantation, is a safe and feasible procedure with a good chance of survival for the transplanted kidney. A customised cooling device is effective and practical during laparoscopic kidney transplantation.
Authors: Thomas Prudhomme; Jean Baptiste Beauval; Marine Lesourd; Mathieu Roumiguié; Karel Decaestecker; Graziano Vignolini; Riccardo Campi; Sergio Serni; Angelo Territo; Luis Gausa; Volkan Tugcu; Selcuk Sahin; Antonio Alcaraz; Mireia Musquera; Michael Stockle; Martin Janssen; Paolo Fornara; Nasreldin Mohammed; Arnaud Del Bello; Nassim Kamar; Federico Sallusto; Alberto Breda; Nicolas Doumerc Journal: World J Urol Date: 2020-06-19 Impact factor: 4.226