A. Bahloul

Does Kidney Transplantation with Multiple Arteries Affect Graft Survival

INTRODUCTION We compared short- and long-term outcomes of renal transplants with single versus multiple arteries. PATIENTS AND METHODS We retrospectively analyzed data from kidney transplants from 208 living donors performed between 1994 and 2010. Renal grafts were divided into two groups: single renal artery (n = 164) versus multiple renal arteries (n = 44). The groups were compared regarding early and late vascular and urological complications. Patient and graft survivals were compared using Kaplan-Meier survivorship curves with comparisons using the log-rank test. RESULTS Both groups were comparable regarding acute rejection episodes, posttransplant hypertension, postsurgery renal artery stenosis, and urologic complications. Only hemorrhagic complications and renal artery thrombosis were significantly higher in the multiple renal arteries group (P = .027 and .03, respectively). Warm ischemia time was significantly longer in the multiple renal arteries group without any influence on the incidence of acute tubular necrosis (P = .2). Mean creatinine clearance at 1 year was 65 versus 50 mL/min/1.73 m(2) (P = .5) and at 5 years, 60 versus 55 mL/min/1.73 m(2) (P = .1) for the single versus multiple renal arteries groups, respectively. Return to hemodialysis was necessary for 18.8% of the single and 16.1% of the multiple renal arteries group. CONCLUSION The use of an allograft with multiple renal arteries is a safe, successful surgical procedure, that does not influence patient or graft survivals or increase surgical complication rates provided the surgical team is evolved with technical skill.

Ectopie testiculaire croisée: à propos d’un cas

ResumeL’ectopie testiculaire croisée ou transverse est une anomalie congénitale rare de la migration testiculaire. Un peu plus de cent cas sont répertoriés dans la littérature.Les auteurs rapportent un nouveau cas d’ectopie testiculaire croisée chez un garçon de 4 ans découverte fortuitement lors d’une cure d’hernie inguino-scrotale droite avec testicule gauche cryptorchide non palpable.Un abaissement testiculaire bilatéral avec positionnement du testicule controlatéral par voie transeptale a été réalisé. L’évolution a été favorable avec un recul de 12 mois.AbstractCrossed testicular ectopia, also called transverse testicular ectopia, is an uncommon congenital anomaly in which both testes migrate through a single inguinal canal toward the same hemiscrotum. More than 100 cases have been reported in the literature. This rare syndrome is commonly associated with abnormalities of genitourinary development, especially inguinal hernia and defective Müllerian regression.A conservative approach is recommended, now performed via laparoscopy. Long-term follow-up is required for assessment of fertility and early detection of testicular malignancy.The authors report a new case of crossed testicular ectopia in a 4-year-old boy who presented with right inguinal hernia and impalpable left testis.