[Vascular complications in kidney transplant patients]

Vascular complications are impotent after kidney Transplantation, They influence on patient and graft survival. There are a lot of factors that play are a role in incidence of these vascular compilations as technical and anatomical ones. The aim is to determine the incidence of vascular complications in kidney transplant patients in addition to signs and symptoms related to these complications, diagnosis modalities, management and results. A retrospective study, including 288 kidney transplant patients, has been performed in Kidney Transplantation Unit in Al-Mouassat University Hospital, from January 2007 until December 2009, all of them are from living donors [relative and non-relative]. Duplex Doppler Ultrasound has been performed routinely one week postoperatively for all patients. In certain cases we performed Ultrasound when signs and symptoms indicated to vascular problems. five cases of renal artery thrombosis [1,7% of patients], four cases of renal vien thrombosis [1,3% of patients], 7 cases of renal artery stenosis [2,4% of patients], The management includes PTA [percutaneous transluminal angioplasty], revision of amastomosis, renal venotomy or arteriotomy and removal of clot, and graft nephrectomy. The incidence of vascular complications in this study is less than that of most international studies, may be the cause is that we use only living donors, not cadaveric ones. The only diagnosis modality is duplex Doppler Ultrasound, we didn't use MRA [Magnetic Resonance Angiogram] or multislices CT. Early surgical exploration may be a salvage procedure leading to management of vascular problem and prevention of graft toss

[ effects of kidney with multiple arteries as a graft from living-donors on the results of kidney transplantation]

The aim of this study is to evaluate the effects of multiple-arteries kidney graft from living-donors on the results of kidney transplantation. The use of multiple-arteries kidney graft was considered in the past a relative contraindication because of high rate of urologic and vascular complication. The lack of organs and disequilibrium between the patients on waiting list and who were operated in kidney transplant centers result in the use of marginal organs [as example: increased blood pressure, Diabetes Mellitus, and the organs with anatomical abnormalities as duplication of urinary tract, multiple arteries, multiple veins]. The medical files of 750 patients transplanted in Kidney Transplant Unit between January 2004 and December 2009 were reviewed. The result were 48 cases with multiple arteries kidney. We performed a retrospective analysis of these 48 patient looking for complications, warm ischemia time, cold ischemia time, vascular anastomosis time, the duration of hospitalization and patient and graft survival. We noticed the following complications: 2 cases: lymphocele [4%], 2 cases: urinary fistula [4%], 2 cases: arterial stenosis [4%], 1 case: arterial thrombosis [2%], 8 cases: delayed graft function [16%]. The mean of warm ischemia time was 58 +/- 4 seconds, the mean of cold ischemia time was 11 +/- 4 minute, the mean of vascular anastomosis time was 32 +/- 7 minute, and the primary hospitalization was 8 +/- 2 days. One - year patient survival was 95.8% and one - year graft survival was 83.3%. This study revealed that the results and the complication rate after the multiple arteries kidney transplantation are comparable to that mentioned in international studies after kidney transplantation in general.