Overview of the surgery of deceased donor renal transplantation
- Ron Shapiro, MD
Ron Shapiro, MD
- Professor of Surgery
- Surgical Director, Kidney/Pancreas Transplant Program
- Mount Sinai Hospital - Recanati Miller Transplantation Institute
- Section Editor
- Daniel C Brennan, MD, FACP
Daniel C Brennan, MD, FACP
- Editor-in-Chief — Nephrology
- Section Editor — Renal Transplantation
- Professor of Medicine
- Medical Director and Co-Director of the Comprehensive Transplant Center, Department of Internal Medicine, Division of Nephrology
- Johns Hopkins Medical School
Renal transplantation is the most commonly performed vascularized solid organ transplant. Technically, it is perhaps the easiest transplant procedure to perform and has the added security of the ability to provide dialysis in patients who experience delayed allograft function [1-4]. However, it is unforgiving of technical error and can present specific challenges in the case of particular recipient or donor issues.
The basic elements of backtable preparation of the deceased-donor kidney and the features of implantation in adults and children will be discussed here. The complications associated with this procedure are presented separately.
The anatomic structures that are transplanted during a deceased-donor kidney transplant usually consist of the kidney, with most of the perinephric fat removed, and the following anatomic structures:
●Renal artery(ies) usually with a cuff of the donor aorta
●Renal vein(s) usually with a cuff of the inferior vena cava for the left kidney or the entire inferior vena cava for the right kidney
- Shapiro R. The transplant procedure. In: Renal Transplantation, Shapiro R, Simmons RL, Starzl TE (Eds), Appleton & Lange, Stamford, CT 1998.
- Ellis D, Gilboa N, Bellinger M, Shapiro R. Renal transplantation in infants and children. In: Renal Transplantation, Shapiro R, Simmons RL, Starzl TE (Eds), Appleton & Lange, Stamford, CT 1998.
- Wood KE, Becker BN, McCartney JG, et al. Care of the potential organ donor. N Engl J Med 2004; 351:2730.
- Humar A, Matas AJ. Surgical complications after kidney transplantation. Semin Dial 2005; 18:505.