The miracle of a kidney transplant that saved the ischemic kidney which lasted for up to 24 hours

11/08/2020 14:00

Recently, doctors at Viet Duc University Hospital have successfully performed an autologous kidney transplant for patient named L.V.D (57 years old) in Kim Thanh (Hai Duong), who suffered a kidney artery thrombosis for up to 24 hours due to a motorbike accident.

 

After being diagnosed with a spinal injury at the provincial hospital, the patient was transferred to Viet Duc Friendship Hospital, performed a scan and detected that the right kidney has got an upper artery thrombosis which leads to the loss of blood supply to the upper pole. The left kidney was completely ischemic, reduced kidney function, and also has some signs of kidney failure.

 

The patient was consulted involving interdisciplinary discussion from Urology – Cardiology – Organ transplant. In the end, they decided to perform an emergency surgery to explore and try at their best to save the left kidney, avoiding kidney failure due to multiple injuries.

 

Dr. Le Nguyen Vu, MD, Organ Transplant Center – Viet Duc Friendship Hospital, who directly participated in the surgery, said: Usually with kidney artery thrombosis, surgery early from 6 to 8 hours after the accident can save the kidney, but in this case, when the patient was transferred to the operating room, it was 24 hours, which past the golden time for a self-kidney transplant.

 

Due to the thrombosis and endothelial damage of the renal artery, doctors had to perform meticulous dissections to obtain maximum renal artery length. The renal artery is taken close to the base of the abdominal aorta to check the full length of the artery. If any segment has endothelial damage, they will remove it for the hope that the remaining renal artery is long enough to connect to the patient’s pelvic artery.

 

The surgical team followed the proposed plan, carrying out two parallel team for kidney irrigation – one for the left kidney transplant and organs examination in the abdomen, diaphragm and one for preserving the right kidney.

 

At the same time, doctors conducted to pump thrombolytic solution in hopes of pushing out blood clots in the small blood vessels inside the kidney. About 30 minutes after washing, the kidney was white and grafted into the left pelvic fossa.

 

In case, a patient has no symptoms of kidney failure, it isn’t necessary to perform the transplant and can live with another kidney, but in this case, Mr. D has already shown signs of kidney failure, doctors are required to perform a kidney transplant to preserve two kidneys’ normal functions.

The surgery took 6 hours and ended successfully despite renal artery lesions has entered the 24th hour which past the golden time for an autologous kidney transplants. After 10 days of surgery, the patient’s kidney function has returned to normal.

 

 Associate .Professor .Dr Do Truong Thanh – Head of Urology Surgery Department, who led the surgery, said this case was really a miracle, although the patient’s kidney had been anemic for a long time, but the blood vessels in the kidney hadn’t been blocked and the kidneys after washing were not purple and black. This is a blessing for the patient that he is able to keep his kidneys’ normal functions for long-term life.