Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research Center

Compromised inferior vena cava (IVC) is a rare but life-threatening condition in low-birth-weight children who require kidney transplantation (KT) to survive.Objective: to demonstrate a comprehensive approach to KT in children with IVC atresia.Materials and methods. In the period from December 2019...

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Main Authors: D. A. Saydulaev, A. A. Zharikov, A. A. Kartashev, P. M. Gadzhieva, A. R. Karapityan
Format: Article
Language:Russian
Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2025-01-01
Series:Вестник трансплантологии и искусственных органов
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Online Access:https://journal.transpl.ru/vtio/article/view/1830
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author D. A. Saydulaev
A. A. Zharikov
A. A. Kartashev
P. M. Gadzhieva
A. R. Karapityan
author_facet D. A. Saydulaev
A. A. Zharikov
A. A. Kartashev
P. M. Gadzhieva
A. R. Karapityan
author_sort D. A. Saydulaev
collection DOAJ
description Compromised inferior vena cava (IVC) is a rare but life-threatening condition in low-birth-weight children who require kidney transplantation (KT) to survive.Objective: to demonstrate a comprehensive approach to KT in children with IVC atresia.Materials and methods. In the period from December 2019 to April 2024, 5 kidney transplants were performed in children with atresia or obliteration of the IVC at Shumakov National Medical Research Center of Transplantology and Artificial Organs. The average age of the children at transplantation was 4.6 ± 2.7 (from 1 to 8 years) years, body weight 13.5 ± 4 (from 8.3 to 19.5) kg. Results. Vertical midline transperitoneal approach was performed, the right lobe of the liver, as well as the accessible part of the subhepatic IVC were partially mobilized. The renal graft was positioned on the right side with the formation of venous anastomosis with the accessible part of the subhepatic IVC. All the children had primary graft function. There were no acute rejection episodes at year 1 post-transplant. The average renal graft glomerular filtration rates in recipients at 3 months and at 1 year post-transplant were 95.9 ± 9.6 ml/min per 1.73 m2 and 80.6 ± 26.2 ml/min per 1.73 m2, respectively. Conclusion. When the iliac veins and/or distal IVC are compromised, venous outflow into an accessible IVC segment is the preferred option. Transplantation in the left orthotopic position and other mentioned revascularization techniques are complex surgical techniques with a higher risk of thrombotic complications in the early postoperative period.
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spelling doaj-art-76e076af315f4b739c6dcc1ead2bc4d52025-08-20T03:59:53ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912025-01-0126481310.15825/1995-1191-2024-4-8-131300Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research CenterD. A. Saydulaev0A. A. Zharikov1A. A. Kartashev2P. M. Gadzhieva3A. R. Karapityan4Shumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansCompromised inferior vena cava (IVC) is a rare but life-threatening condition in low-birth-weight children who require kidney transplantation (KT) to survive.Objective: to demonstrate a comprehensive approach to KT in children with IVC atresia.Materials and methods. In the period from December 2019 to April 2024, 5 kidney transplants were performed in children with atresia or obliteration of the IVC at Shumakov National Medical Research Center of Transplantology and Artificial Organs. The average age of the children at transplantation was 4.6 ± 2.7 (from 1 to 8 years) years, body weight 13.5 ± 4 (from 8.3 to 19.5) kg. Results. Vertical midline transperitoneal approach was performed, the right lobe of the liver, as well as the accessible part of the subhepatic IVC were partially mobilized. The renal graft was positioned on the right side with the formation of venous anastomosis with the accessible part of the subhepatic IVC. All the children had primary graft function. There were no acute rejection episodes at year 1 post-transplant. The average renal graft glomerular filtration rates in recipients at 3 months and at 1 year post-transplant were 95.9 ± 9.6 ml/min per 1.73 m2 and 80.6 ± 26.2 ml/min per 1.73 m2, respectively. Conclusion. When the iliac veins and/or distal IVC are compromised, venous outflow into an accessible IVC segment is the preferred option. Transplantation in the left orthotopic position and other mentioned revascularization techniques are complex surgical techniques with a higher risk of thrombotic complications in the early postoperative period.https://journal.transpl.ru/vtio/article/view/1830kidney transplantation in childrenpediatric kidney transplantationinferior vena cava
spellingShingle D. A. Saydulaev
A. A. Zharikov
A. A. Kartashev
P. M. Gadzhieva
A. R. Karapityan
Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research Center
Вестник трансплантологии и искусственных органов
kidney transplantation in children
pediatric kidney transplantation
inferior vena cava
title Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research Center
title_full Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research Center
title_fullStr Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research Center
title_full_unstemmed Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research Center
title_short Kidney transplantation in children with a compromised inferior vena cava: a unique experience at Shumakov Research Center
title_sort kidney transplantation in children with a compromised inferior vena cava a unique experience at shumakov research center
topic kidney transplantation in children
pediatric kidney transplantation
inferior vena cava
url https://journal.transpl.ru/vtio/article/view/1830
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