pISSN 3022-6783
eISSN 3022-7712


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Korean J Transplant 2022; 36(4): 253-258

Published online December 31, 2022


© The Korean Society for Transplantation

Retrograde reperfusion of renal grafts to reduce ischemic-reperfusion injury

Myltykbay Rysmakhanov1 , Aibolat Smagulov1 , Nadiar Mussin1 , Asset Kaliyev1 , Bazylbek Zhakiyev1 , Yerlan Sultangereyev1 , Gani Kuttymuratov2

1Department of Surgery No. 2, West Kazakhstan Medical University, Aktobe, Kazakhstan
2Department of Surgery and Organ Transplantation, Aktobe Medical Center, Aktobe, Kazakhstan

Correspondence to: Myltykbay Rysmakhanov
Department of Surgery No. 2, West Kazakhstan Medical University, 68 Maresyev St, Aktobe 030012, Kazakhstan
Tel: +7-7770-36-56-90
Fax: +7-7132-53-42-45
E-mail: mrtransplantolog@gmail.com

Received: November 1, 2022; Revised: November 28, 2022; Accepted: December 5, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: During transplantation, a kidney graft undergoes a cascade of pathological changes, referred to as ischemia-reperfusion injury (IRI), as it is incorporated into the bloodstream. Various studies have reported that retrograde reperfusion (RRP) leads to improved myocardial recovery and could reduce IRI in liver transplantation. This study investigated the effect of RRP in renal transplantation with a focus on reduction of kidney IRI.
Methods: Between December 2019 and July 2022, 15 consecutive kidney transplants were performed with retrograde venous reperfusion. To conduct a comparative study and to recruit a control group, 15 kidney transplants that had been performed in the same center by the same two surgeons were retrospectively analyzed. Differences between the two groups were considered statistically significant at P<0.05.
Results: The baseline characteristics of the two groups were statistically comparable (P>0.05). The surgical technique for kidney transplantation was the same in both groups. On the first postoperative day, polyuria was less pronounced in the RRP group (P<0.01). Serum creatinine and urea levels and estimated glomerular filtration rates on postoperative days 1, 4, 7, and 30 were lower in the RRP group (P<0.05).
Conclusions: Retrograde venous reperfusion of a kidney transplant, preceding antegrade arterial reperfusion, reduced the effects of renal parenchyma IRI. To validate the results of this study, it is necessary to conduct further studies on a larger cohort of patients with a longer follow-up period.

Keywords: Kidney transplantation, Injuries, Ischemia reperfusion

  • Ischemia-reperfusion injuries in grafts remain an important problem in transplantation.

  • Retrograde reperfusion of organs has been performed in cardiac surgery and during liver transplantation.

  • Retrograde reperfusion of a transplanted kidney is easy to perform and can reduce the degree of ischemia-reperfusion injury.