Extension of right renal vein in renal transplant from deceased donors: cohort study.

OBJECTIVES: Throughout the world, 45 000 kidney transplants are performed per year. Graft and overall survival vary according to the type of donor (living or deceased donor). Anastomosis of a short renal vein with iliac vein or common external iliac vein has been associated with technical problems such as angulation of the vein or tension on the anastomosis, which could limit visualization and control of bleeding from the graft. The main objective of our study was to analyze patients undergoing deceased-donor kidney transplant and compare results in patients who had extension of the right renal vein with a patch of vena cava from the same donor versus patients who received the left kidney. MATERIALS AND METHODS: A prospective cohort study was performed from December 31, 2007 to December 31, 2009. We compared 2 patients groups. We used statistical software (R, Version 2.5.1). The analyzing team was blinded to the surgical technique, and informed consent was obtained from all patients. RESULTS: There was no statistically significant difference in surgical time (P > .85) or ultrasonographic parameters between groups, but it was possible to perform an easier vein anastomosis with the vena cava graft in right kidney transplant. CONCLUSIONS: We recommend considering our procedure with the vena cava graft in right kidney as an alternative option to decrease warm ischemia time, perform an easier vein anastomosis with the vena cava extension, and make the procedure comfortable for the surgeon.

[Renal transplantation in Maastricht II asystole: report of a first case in Mexico]. / Trasplante renal en asistolia Maastrich II. Reporte del primer caso en México.

On May 6, 2012, an 18-year-old patient was admitted to the emergency room with sever traumatic brain injury and cardiovascular arrest; resuscitation maneuvers were started with a compressor table AUTOPULSE®. After 30 minutes, death was pronounced. Later, compressions were restarted. After the family agreed with the donation, blood samples were obtained to do serology tests and to obtain blood group and Rh factor and a cardiopulmonary bypass was started by femoral approach. After 2 hours and 35 minutes, extraction of the kidneys was performed. This case represented the first organ procurement from a non-heart-beating Maastricht II donor in our country. After 60 days, both receptors remained free of dialysis.

[Experience in kidney transplantation from 1999 to 2011 at the Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí]. / Experiencia en trasplante renal, de 1999-2011, en el Hospital Central Dr. Ignacio Morones Prieto de San Luis Potosi.

INTRODUCTION: In April 1991 was performed the first kidney transplant at the Hospital Central Dr. Ignacio Morones Prieto. In August 1999, formally started the kidney transplant program. OBJECTIVE: To describe the experience in kidney transplant at HCIMP. MATERIALS AND METHODS: Retrospective cohort study, which includes all kidney transplants performed during the period August 1999 to June 2011. We excluded patients whose medical record was eliminated or with incomplete data for analysis. It describes the general characteristics of kidney transplant recipients, transplant-related variables, initial immunosuppression and complications. The survival analysis was performed using the Kaplan-Meier method. The curves were compared using the log-rank test. RESULTS: From August 1999 to June 2011 were performed 517 kidney transplants at Central Hospital, of which 411 patients were analyzed. Ten years overall graft-survival was 73%. Both, the history of infection or acute rejection were associated with lower graft survival. The main cause of death, in our population, was infectious processes. CONCLUSION: Graft survival at 10 years was 73%, which is similar to that reported in the literature. A history of acute rejection and infection are factors associated with lower survival.