Simultaneous right-sided nephrectomy with orthotopic liver and kidney transplantation—An alternative method for patients with autosomal dominant polycystic liver and kidney disease
| Autor: | Philipp Felgendreff, Felix Dondorf, Falk Rauchfuss, Sascha Lux, Hans-Michael Tautenhahn, Utz Settmacher, René Aschenbach |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030230 surgery Liver transplantation Nephrectomy How-I-Do-It articles Organ transplantation Kidney transplantation 03 medical and health sciences 0302 clinical medicine medicine Humans Autosomal dominant polycystic liver and kidney disease Retrospective Studies business.industry Polycystic Kidney Autosomal Dominant medicine.disease Urinoma Surgery Cardiac surgery Transplantation surgical procedures operative Liver 030211 gastroenterology & hepatology business Kidney disease |
| Zdroj: | Langenbeck's Archives of Surgery |
| ISSN: | 1435-2451 1435-2443 |
| Popis: | Purpose In patients suffering from autosomal dominant polycystic liver and kidney disease (ADPLKD), combined organ transplantation often poses a technical challenge due to the large volume of both organs. To simplify the transplantation procedure by improving the exposure of anatomical structures, we introduce a novel surgical technique of orthotopic liver and kidney transplantation. Methods The modified simultaneous liver and kidney transplantation technique via a right-sided L-incision included three steps: (1) right-sided nephrectomy in the recipient followed by (2) orthotopic liver transplantation in cava replacement technique and (3) the orthotopic kidney transplantation with arterial reconstruction to the right common iliac artery. Results In total, seven patients with ADPLKD were transplanted by using the modified transplantation technique. The mean operation time was 342.43 min (±68.77). Postoperative patients were treated for 6.28 days (±2.50) in the intensive care unit and were discharged from the surgical ward approximately 28 days (±5.66) after the operation with normal graft function. Complications associated with the use of the modified technique, such as bleeding, anastomotic stenosis, biloma, or urinoma, did not occur. Conclusion Modified simultaneous liver and kidney transplantation is a safe alternative for patients with ADPLKD. By combining right-sided nephrectomy and orthotopic graft transplantation, the approach optimizes the exposure of anatomical structures and simplifies the transplantation procedure. Additionally, the modified transplantation technique does not require a particular organ explantation procedure and can be applied for all liver and kidney grafts. |
| Databáze: | OpenAIRE |
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