An Answer to a Transplant Problem

The failure of an organ is, for all intents and purposes, a death sentence as it will eventually lead to system-wide failure. Research has brought many advances to stave off negative outcomes, but none of these are a cure. One treatment for end-stage kidney disease is transplantation. It is actually a cure that not only makes a patient more comfortable but also extends their life. However, the list of those willing to donate organs is exceeded by the number of those who need an organ. There are more than 103,000 people in the U.S. on the National Transplant Organ list. Of those, more than 90,000 are waiting for a kidney. Kidney transplants from living donors are preferred because the graft's survival is better than from a deceased donor. The left kidney is preferred because it has a longer renal vein. However, if the donor is prevented from donating the left kidney, and the right kidney is used, the right vein may prove more difficult venous anastomosis, especially in patients with higher BMI or a deeper pelvis. To combat this, multiple methods have been described to increase the length of the renal veins. A team of researchers at Houston Methodist looked at a less described option, the use of renal vein extension grafts from a deceased patient to improve anastomosis. The researchers reviewed the results of all 45 kidney transplant recipients at a single center over a five-year period who received a right-side organ, including those who received a renal vein extension using a deceased donor iliac vein (38), autologous internal jugular vein extension (4), or no vein extension (3). The cause for kidney failure in most of the patients was either diabetes or high blood pressure.