Renal Transplantation
Objective
In case of renal failure:
• Kidney
from live donar
• Or
kidney from cadaver is transplanted to restore renal function.
Position
Supine.
Anesthesia
General.
Procedure
1. In live donor a nephrectomy is carried out as described care is
mobilizing renal artery and vein so as not to injure them.
2. Ureter is similarly mobilized with perureteric
tissue. Kidney perfused with cold irrigating fluid.
3. The iliac fossa of patient (RP) is used.
4. Oblique muscle cutting used for access.
5. Peritoneum pushed medially.
6. Internal iliac artery mobilized branches
ligated.
7. External iliac vein mobilized.
8. Donor kidney renal vein anastomosed to
external iliac vein.
9. End of internal iliac artery anastomosed to
donor kidney renal artery.
10. Ureter is implanted to bladder.
11. Wound closed after placing kidney iliac fossa.
Instruments
• General set
• Laparotomy
set
• Deep
set
• Vascular
clamps (Potts, De Bakey or Satinsky), 2
• Large
bulldog clamps (Potts), 4 (Fig. 8.126)
• Small
bulldong clamps (Potts), 4
• Heparinized
saline, and syringes with cannulae
• Suction
tubing, nozzles and tube anchoring forceps
• Diathermy
leads, electrodes and lead anchoring forceps
• Tantalum
marker clips and insertion forceps
• Laparotomy
ligatures and sutures
• 1
and 0.75 (5/0 and 6/0) Synthetic nonabsorbable or silk on small fine curved
arterial needles for anastomosis.
Any questions be sent to drmmkapur@gmail.com
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