Right renal vein lengthening with cava patch in cadaveric donor kidney transplantation: cohort study

Jorge Martinez Ulloa-Torres, Idalia Parra-Avila, Paulo Gutierrez-Torres, Belem Arieth Chan-Canche, Daniel Moo-Rivas Carlos, Juan Pablo Baas-Cruz, Luis Fernanado Aguilar-Castillejos, Mauro Enrique Tun-Abraham, Jesus Manual Bernal-Mier


Background: Right kidney transplant can become a surgical challenge, due to anatomical length disparity between the right and left veins. From 2011, lengthening of the right renal vein has been used in our program. The objective was to evaluate the outcome among kidney transplant recipients with or without the use of a cava patch, comparing safety, complications and patient / graft survival in both groups.

Methods: Retrospective single center cohort study between 2011-2020 in a Kidney transplant program at Mexico.

Results: 27 right cadaveric kidney transplant recipients were identified, 13 (48%) with and 14 (52%) without right renal vein lengthening (RRVL). Median overall operative time was 135 (120-157) minutes, with no significant difference between groups (p=0.181), even in overweight or obese recipients. Perioperative bleeding and postoperative drainage output was similar in both groups. There were two graft failures among recipients without RRVL one due to arterial bleeding and the other secondary to venous thrombosis. After one year of follow up, renal graft function and graft survival was similar in both groups.

Conclusions: RRVL technique is safe and facilitates anastomoses in complex cases. Although no statistically significant difference in operative time was found between the groups, the RRVL technique in overweight / obese patients was thirty minutes faster. Routine use of this technique is suggested in cadaveric donor right kidney transplants.


Right kidney transplant, Cava patch, Bench-surgery

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