A method of surgical treatment of microcysticis in combination with terminal chronic renal failure in an experiment

Abstract

The invention pertains to the field of medicine, specifically organ and tissue transplantation, and can be used for the surgical treatment of microcystis cystis associated with end-stage renal failure. The technical result is achieved by allogeneic transplantation of a donor kidney, the recipient's own ureter, a portion of the bladder, and the lower third of the contralateral ureter as a single unit. The method is implemented as follows. First, the recipient prepares a site for implantation of the donor kidney in the iliac region; the iliac vein and artery (common or external, depending on the size of the donor kidney and the body weight of the recipient), half of the upper part of the bladder, and the distal part of the ureter of the opposite native kidney are mobilized. A single donor kidney, along with its native ureter, a portion of the bladder, and the lower third of the contralateral ureter, is removed, perfused, and preserved en bloc from a deceased donor and then implanted into the recipient. The kidney is placed in the iliac fossa, and vascular (vein and artery) anastomoses are created between the donor kidney and the recipient's iliac vein and artery. The donor kidney is reperfused, after which the recipient's bladder wall is incised to a circumference corresponding to the diameter of the donor bladder. A two-layer anastomosis is created between the donor bladder and the recipient's own bladder. Next, the ureter of the opposite kidney is incised at the lower third level, and the distal ureter is either ligated or sutured. The distal portion of the donor's contralateral ureter, originating from the bladder, is anastomosed with the distal portion of the proximal ureter of the recipient's own kidney end-to-end using a ureteral stent. The engraftment of the donor portion of the bladder occurs due to vascularization from the kidney and ureter, as well as the restoration of blood supply from the walls of the donor's own bladder and the distal part of the donor's ureter, which in turn is supplied with blood from the proximal ureter of the recipient's own kidney.