Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each
CPT4 code
Name of the Procedure:
Backbench Reconstruction of Cadaver or Living Donor Renal Allograft Prior to Transplantation; Venous Anastomosis
Summary
This procedure involves the preparation and surgical connection of veins in a donor kidney before it is transplanted into a recipient. It is a critical step to ensure the donor kidney is ready for successful transplantation.
Purpose
The procedure addresses renal failure or end-stage kidney disease, preparing a donated kidney for transplantation to restore kidney function in the recipient. The goal is to create a functional connection for blood flow through the donor kidney.
Indications
- End-stage renal disease
- Chronic kidney failure
- Kidney damage that requires transplantation
- Patients who need kidney transplantation to improve quality of life
Preparation
- Fasting (usually after midnight before surgery)
- Adjustment or cessation of certain medications as advised
- Pre-operative diagnostic tests (e.g., blood tests, imaging studies, cross-matching)
Procedure Description
- The donor kidney is removed from the cadaver or living donor.
- The kidney is transported to a sterile environment where it is kept on ice.
- The surgical team prepares the kidney for transplantation by cleaning and flushing it.
- Venous anastomosis is performed where the surgeon connects the donor kidney's veins to ensure adequate blood flow once transplanted.
- Specialized surgical instruments and sutures are used.
- If the procedure involves a living donor, both the donor and recipient will be under general anesthesia.
Duration
The procedure typically takes about 1 to 2 hours, but this can vary based on complexity.
Setting
Performed in a hospital, specifically in an operating room or transplant surgery suite.
Personnel
- Transplant surgeons
- Surgical nurses
- Anesthesiologists
- Transplant coordinators
Risks and Complications
- Bleeding
- Infection
- Blood clot formation
- Organ rejection
- Vascular complications
- Anesthesia-related risks
Benefits
- Enhanced blood flow through the transplanted kidney.
- Improved chances of successful kidney function post-transplant.
- Potential for a higher quality of life once the recipient's renal function is restored.
Recovery
- Close monitoring in a hospital post-transplant.
- Pain management and antibiotics to prevent infection.
- Gradual resumption of activities as advised by the healthcare team.
- Regular follow-up appointments to monitor kidney function.
Alternatives
- Dialysis (hemodialysis or peritoneal dialysis)
- Continuing with current management of kidney disease
- Seeking another donor if complications arise with the initial donor kidney
Patient Experience
- General anesthesia ensures the patient is unconscious and pain-free during the procedure.
- Post-operative discomfort managed with pain medication.
- The patient may feel weak or fatigued initially, with gradual recovery over time.