Liver bench surgery: carefully dissect the donor inferior vena cava, especially in the suprahepatic region, where the adventitia is firmly adherent to the surrounding diaphragm, and on the posterior side to avoid uncontrollable posterior bleeding during implantation. Recognize hepatic artery variations (Michel’s classification) when examining the superior mesenteric artery. Dissect the hepatic artery from the aortic patch to the level of bifurcation of the gastroduodenal artery, cleaning off the celiac plexus and fibrofatty tissue enveloping the vessels. Do not ligate the small collaterals too near to the vascular ostia, especially in atheromasic arteries. Kidney bench surgery: carefully remove the perinephric fat without skeletonizing the ureters; avoid extensive opening and massive cleaning of perinephric fat in kidneys from older donors. Mark and subtend both the ureters with light mosquito forceps to avoid their accidental shortening and injury. Cut the left renal vein along the left margin of the vena cava. Choose the right renal vein elongation technique that is most appropriate according to the shape of the vein. Pay special attention to the inferior polar arteries, which often originate far from the main renal artery, from the inferior abdominal aorta, or from the iliac axis. Pancreas bench surgery: manipulate the pancreas parenchyma very carefully to minimize edema, injuries, and bleeding, all factors which increase the risk of acute pancreatitis of the graft.
Transplantation bench surgery of the abdominal organs / R. Sguinzi, R. De Carlis, M. Vertemati, O. Rossetti, P. Aseni - In: Multiorgan procurement for transplantation / [a cura di] P. Aseni, A.M. Grande, L. De Carlis. - Prima edizione. - Ebook. - [s.l] : Springer International Publishing Switzerland, 2016. - ISBN 9783319284149. - pp. 197-212 [10.1007/978-3-319-28416-3_18]
Transplantation bench surgery of the abdominal organs
M. Vertemati;
2016
Abstract
Liver bench surgery: carefully dissect the donor inferior vena cava, especially in the suprahepatic region, where the adventitia is firmly adherent to the surrounding diaphragm, and on the posterior side to avoid uncontrollable posterior bleeding during implantation. Recognize hepatic artery variations (Michel’s classification) when examining the superior mesenteric artery. Dissect the hepatic artery from the aortic patch to the level of bifurcation of the gastroduodenal artery, cleaning off the celiac plexus and fibrofatty tissue enveloping the vessels. Do not ligate the small collaterals too near to the vascular ostia, especially in atheromasic arteries. Kidney bench surgery: carefully remove the perinephric fat without skeletonizing the ureters; avoid extensive opening and massive cleaning of perinephric fat in kidneys from older donors. Mark and subtend both the ureters with light mosquito forceps to avoid their accidental shortening and injury. Cut the left renal vein along the left margin of the vena cava. Choose the right renal vein elongation technique that is most appropriate according to the shape of the vein. Pay special attention to the inferior polar arteries, which often originate far from the main renal artery, from the inferior abdominal aorta, or from the iliac axis. Pancreas bench surgery: manipulate the pancreas parenchyma very carefully to minimize edema, injuries, and bleeding, all factors which increase the risk of acute pancreatitis of the graft.File | Dimensione | Formato | |
---|---|---|---|
10.1007%2F978-3-319-28416-3_18.pdf
accesso riservato
Tipologia:
Publisher's version/PDF
Dimensione
1.2 MB
Formato
Adobe PDF
|
1.2 MB | Adobe PDF | Visualizza/Apri Richiedi una copia |
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.