Renal Transplantation With Size-Matched End-to-End Venous Anastomosis in Children With Inferior Vena Cava Thrombosis

Abstract

Due to surgical technical difficulties, inferior vena cava (VCI) thrombosis is contraindicated for renal transplantation in pediatric patients. Of 287 pediatric renal transplantations, 3 patients (9, 12, and 19 kg, respectively) with end-stage renal failure, who had VCI thrombosis at the level of renal vein, underwent end-to-end anastomosis to the proximal aspect of VCI for venous drainage. The latest creatinine values of the patients, who were in the postoperative 56th, 28th, and 14th months, were 0.6, 0.4, and 0.3 mg/dL, respectively, with graft and patient survival rates of 100%. We think that end-to-end venous drainage into the proximal caval system is the most appropriate surgical approach in pediatric recipients, who have an open suprarenal VCI and a small intra-abdominal cavity, in the presence of an appropriate size-matched graft.