İlker ARER, Hakan YABANOĞLU, Kenan ÇALIŞKAN, Alper PARLAKGÜMÜŞ, Sedat YILDIRIM, Gökhan MORAY, Mehmet HABERAL

Böbrek Transplantasyon Donörlerinde Vasküler Farklılıklar ve Anastomoz Teknikleri

Amaç: Donör nefrektomileri vasküler farklılık ve anastomoz teknikleri açısından inceleyerek bu konudaki tecrübelerimizi paylaşmayı amaçladık. Materyal ve Metod: Şubat 2010 ile Haziran 2014 tarihleri arasında merkezimizde donör nefrektomi ameliyatı yapılan 128 hasta dahil edildi. Donörler yaş, cinsiyet, ek hastalık, geçirilmiş ameliyat varlığı, donör nefrektomi yapılan taraf, vasküler farklılık ve anastomoz tekniği açısından geriye dönük olarak incelendi. Bulgular: Hastaların 21 (%16,4)’ünde solda, 19 (%14,8)' da sağda ve 13 (%10,2)'ünde bilateral vasküler farklılık mevcuttu. Saptanan vasküler farklılıklar ise sırasıyla; hastaların 29 (%21,2)' da unilateral çift renal arter, 8 (%6,3)' de unilateral çift renal arter ve çift renal ven, 4 (%3,2)' de unilateral üç renal arter, 3 (%2,4)' de erken dallanan renal arter, 2 (%1,6)' de unilateral çift renal ven, 2 (%1,6)' de polar arterdir. Vasküler anastomoz tipi ise; 92 (%71,9) renal transplantasyon hastasında renal ven ile eksternal iliyak ven arasında uç-yan ve renal arter ile eksternal iliyak arter arasında uç-yan, 32 (%25) hastada renal ven ile eksternal iliyak ven arasında uç-yan ve renal arter ile internal iliyak arter arasında uç-uca iken 4 (%3,1) hastada renal ven ile eksternal iliyak ven arasında uç-yan, renal arter ile eksternal iliyak arter arasında uç-yan ve 2. renal arter ile internal iliyak arter arasında uç-uca yapılmıştır. Sonuç: Böbrek transplantasyonunda ameliyat öncesi donörlerin vasküler farklılıklarının incelenmesi hem nefrektomi yapılacak böbreğin seçiminde hem de ameliyat sırasında diseksiyon yaparken vasküler anatomiye hakim olarak komplikasyonu azaltmada etkisi olacağından ciddi önem taşımaktadır.

Anahtar Kelimeler:

Donör nefrektomi, vasküler varyasyon, anastomoz

Vascular Variations and Anastomosis Techniques in Renal Transplant Donors

Purpose: We aimed to share our experience about vascular variations and anastomosis tecniques in renal transplant donors. Material and Methods: 128 donor nephrectomy performed in our hospital between February 2010 and June 2014 were included in our study. Donors were retrospectively analyzed according to age, sex, comorbidity, operation history, site of nephrectomy, vascular variation and anastomosis techniques. Results: 21 (%16,4) patients have left-sided, 19 (%14,8) have right-sided and 13 (%10,2) have bilateral vascular variation. 29 (%21,2) unilateral double renal artery, 8 (%6,3) unilateral double renal artery and vein, 4 (%3,2) unilateral triple renal artery, 3 (%2,4) early branching renal artery, 2 (%1,6) unilateral double renal vein and 2 (%1,6) polar artery are vascular variations observed. of 92 (%71,9) recepients anastomosis type was end to side between renal artery and external iliac artery and end to side between renal vein and external iliac vein, 32 (%25) end to end between renal artery and external iliac artery and end to side between renal vein and external iliac vein, 4 (%3,1) end to side between renal artery and external iliac artery and end to side between renal vein and external iliac vein and end to side between 2nd renal artery and external iliac artery. Conclusion: Preoperative evaluation of renal vasculature of transplant donors is an important issue in means of decreasing peroperative vascular complications and decision for nephrectomy site.

Keywords:

Donor nephrectomy, vascular variation, anastomosis,

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