Effects of Graft Vascular Dimensions on Surgical and Functional Outcomes of Living Donor Kidney Transplantation

Study Overview
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Brief Summary
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Correlate the radiological and intraoperative measuring of the vascular dimensions, Assess the effect of the vascular dimensions on the short-term surgical complications and Assess the effect of the vascular dimensions on the primary graft function in pediatric and adults KTs.

Detailed Description
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Vascular complications after kidney transplantation (KT) are variably rare with an incidence of 3-15%. They are a significant and most serious part of surgical complications of KT. They may acutely result in graft loss during surgery or early in the perioperative period and may threaten patient's life. The most common forms of early vascular complications are haemorrhage, hematomas, arterial or venous thrombosis, arterial vasospasm, and arterial intimal dissection. In pediatric and adult KT, most studies addressing the vascular complications followed a common attitude of estimating the prevalence and management of these complications rather than studying the predisposing factors. Specifically, studying the normal and abnormal anatomy of the grafts has mainly been directed towards the number of graft vessels. However, there are many other vascular parameters that may potentially influence the outcome of vascular anastomosis and therefore the graft and patient outcomes. To the best of the investigators knowledge, the vascular dimensions of the renal and iliac vessels, such as the length, diameter and site of anastomosis to the iliac vessels have not been studied before so the investigators hypothesis that these dimensions can unequally affect the outcomes of surgery and early graft function in KTs. Hence, this study will be conducted to assess the effects of the vascular dimensions on the outcomes of surgery and primary graft function in pediatric versus adult living donor KT.

Official Title
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Effects of Graft Vascular Dimensions on Perioperative Surgical and Functional Outcomes of Living Donor Kidney Transplantation in Pediatrics and Adults: A Prospective Case Series

Conditions
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Kidney Transplant; Complications

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pediatric and adult patients undergoing living donor kidney transplantation. Exclusion Criteria: Patients with acute graft rejection occurring within the first week of transplantation. Patients refusing participation in the study.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mode of graft function defined by: 1- the time of start of diuresis post-transplantation. | Mode of graft function defined by: 1- the start of diuresis (sufficient amount of urine production) within one hour of declamping through the first week post-transplantation | one month post operative. | 
| 2- Rate of decline of the serum creatinine level. | 2- Rate of decline of the serum creatinine level. | one month post operative. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The rate of vascular complications (intra- or perioperative). | The rate of vascular complications (intra- or perioperative): In the form of spasm, hemorrhage, dissection, or thrombosis. | one month post operative | 
| The rate of other surgical complications. | The rate of other surgical complications. | one month post operative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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kidney transplantation, renal transplantation, vascular dimensions, vascular parameters