Name of the Procedure:

Backbench Reconstruction of Cadaver or Living Donor Renal Allograft Prior to Transplantation; Arterial Anastomosis, Each

Summary

This procedure involves preparing a donated kidney (from either a cadaver or living donor) for transplantation by surgically connecting its arteries to ensure proper blood flow once transplanted into the recipient.

Purpose

Medical Condition/Problem:

• End-stage renal disease (ESRD) or chronic kidney failure. ##### Goals/Expectations:
• To ensure the donated kidney has a viable blood supply for successful transplantation and function in the recipient.

Indications

Specific Symptoms or Conditions:

• Patients with ESRD or chronic renal failure who are candidates for kidney transplantation. ##### Patient Criteria:
• Suitable match between donor kidney and recipient.

Preparation

Pre-Procedure Instructions:

• Fasting for several hours before surgery.
• Discontinuation of certain medications as advised. ##### Diagnostic Tests:
• Blood tests, tissue typing, and imaging studies to confirm suitability and compatibility.

Procedure Description

Steps Involved:

1. The donor kidney is removed and preserved.
2. The kidney is placed on a sterile back table (backbench) for intricate preparation.
3. Surgeons carefully connect the donor kidney arteries to ensure they are ready to attach to the recipient’s blood vessels. ##### Tools/Equipment:
   • Microsurgical instruments, sutures, and magnification tools. ##### Anesthesia/Sedation:
   • General anesthesia for both the donor kidney extraction and the recipient’s surgery.

Duration

The backbench reconstruction typically takes 1 to 2 hours, depending on anatomical complexities.

Setting

Performed in a surgical suite within a hospital.

Personnel

• Transplant surgeon
• Surgical nurses
• Anesthesiologist
• Surgical assistants

Risks and Complications

Common Risks:

• Bleeding, infection, blood clots. ##### Rare Risks:
• Damage to the donor kidney, complications from anesthesia. ##### Management:
• Close monitoring, antibiotics for infections, and interventions for bleeding or clots.

Benefits

• Successful arterial connection allows the donor kidney to function effectively in the recipient’s body.
• Improved kidney function and quality of life for the recipient, potentially within days to weeks.

Recovery

Post-Procedure Care:

• Regular monitoring of kidney function and blood flow.
• Medications to prevent rejection and manage pain. ##### Recovery Time:
• Initial hospital stay of 1-2 weeks, with ongoing follow-up for several months.

Alternatives

• Dialysis as a temporary or long-term treatment for kidney failure.
• Waiting for another suitable kidney donation.

Pros/Cons:

• Dialysis: less invasive but not a permanent solution and affects quality of life.
• Alternative kidney transplant: another potential chance but requires suitable donor match and waiting time.

Patient Experience

During Procedure:

• Under general anesthesia, so no awareness or pain during surgery. ##### After Procedure:
• Pain and discomfort managed with medication.
• Regular monitoring and gradual return to daily activities.

Pain management and comfort measures are continually administered to ensure patient well-being throughout the procedure and recovery period.