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ALLOGRAFT RUPTURE

SALVAGE SURGERY FOR ALLOGRAFT RUPTURE Dr. SUNIL SHROFF Department of Urology & Renal Transplantation Sri Ramachandra Medical College & Research Institute (Deemed University) C hennai, India. ALLOGRAFT RUPTURE. 150 Renal Transplants 118 Live Related & 32 Cadavers 4 Allo-graft Ruptures

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ALLOGRAFT RUPTURE

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  1. SALVAGE SURGERY FOR ALLOGRAFT RUPTUREDr. SUNIL SHROFFDepartment of Urology & Renal TransplantationSri Ramachandra Medical College & Research Institute (Deemed University) Chennai, India

  2. ALLOGRAFT RUPTURE

  3. 150 Renal Transplants 118 Live Related & 32 Cadavers 4 Allo-graft Ruptures 1 Cadaver & 3 Live Related Allograft Rupture

  4. Vascular Rejection - 2 ATN – 1 Venous Thrombosis - 1 Cause of Allo-Graft Rupture

  5. In Three of the Graft Ruptures Salvage Surgery Attempted Salvage Surgery

  6. In 2/3 Salvage Surgery Successful ( Vascular Rejection x 1 and ATN x 1) In one patient with Venous Thrombosis salvage unsuccessful Salvage Surgery

  7. Difficult No Preset Surgical Techniques Nothing much Available in surgical literature Salvage Surgery for Allograft Rupture

  8. All our graft rupture involved convex surface of the kidney The steps of the surgery include Meticulous Clearance of all Hematoma surrounding the graft followed by a Complex Repair Salvage Surgery for Allograft Rupture

  9. Continuous Prolene ( 6/0 or 5/0 ) sutures on Renal capsule distant to the site of rupture were used Strips of Muscle , peritoneum and Surgicel interposed in between Prolene Sutures to cover area of rupture In one case super glue – Nectacryl was used for a persistent spot bleeder Technique of Salvage Surgery for Allograft Rupture

  10. Muscle Strip or Gelfoam or Peritoneal strip covering the Ruptured Graft Surgical Technique For Salvaging Allo-Graft Rupture Allo-Graft Rupture On Convex Surface of Kidney

  11. Proline sutures away from site of Rupture GreaterOmental Wrap Surgical Technique For Salvaging Allo-Graft Rupture

  12. The surgery of saving a ruptured graft can be a daunting experience and exercise It should however be first attempted before sacrificing the graft. CONCLUSION

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