A novel technique for suture-free repair of renal allograft rupture.

Background: Renal allograft rupture (RAR) is a rare complication, but it can cause graft loss and be life-threatening. Surgical exploration and repair is essential for saving the kidney graft. The aim of this article is to describe a novel suture-free technique for management of RAR.

Material/methods: Twenty-six RARs were diagnosed in 1851 kidney transplants from November 2002 to November 2008. The study was divided into 2 groups: a suture group and a suture-free group. Twelve cases were treated in the suture group, whereas 14 were treated by the suture-free technique. In the suture-free group, absorbable thread was used to bundle the ruptured renal graft. For the suture group, autologous cubic muscular tissues or external oblique aponeurosis were used as pledgets.

Results: In the suture-free group all 14 grafts were rescued with creatinine (Cr) at 1.8 ± 0.62 mg/dl on discharge. In the suture group all 12 grafts were repaired successfully with Cr 1.9 ± 0.63 mg/dl on discharge. The 1-, 3- and 5-year graft survival rate was 92.8%, 82.5%, 70.50%, respectively, in the suture-free group and 84.1%, 75.5%, 67.4%, respectively, in the suture group. The suture-free technique had shorter operation time, less blood transfusion and shorter hospital stay.

Conclusions: The suture-free technique is a safe and effective technique for treatment of RAR, with advantages of shorter operating time, less blood loss and quicker recovery after surgery.