End-to-Side Interrupted Versus Continuous Arterial Suturing in Living Donor Kidney Transplantation

This study will compare two standard ways of stitching the kidney artery to the iliac artery in adults receiving a living donor kidney transplant. The two techniques are interrupted suturing and continuous suturing. The study will review past transplant cases and follow new patients at Assiut University Urology Hospital. For each patient, the team will record details of the operation, blood flow in the kidney artery, kidney function, and any surgical or vascular complications during the first three months after surgery. The main goals are to see whether one suturing pattern shortens cold ischemia time and improves early blood flow measurements, and to explore how these techniques affect early graft function, complication rates, and short-term graft and patient survival.

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Key information

Conditions

Suture Techniques Continuous Suture Kidney Transplant Suture, Interrupted

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

About this study

This observational study evaluates whether different patterns of arterial suturing during kidney transplantation influence short-term graft function and vascular outcomes in adult living donor kidney recipients. The study compares interrupted versus continuous end-to-side arterial anastomosis to the iliac arteries using standardized surgical and postoperative care pathways.

The research is designed as a combined retrospective and prospective non-randomized comparative cohort study conducted at the Assiut Kidney Transplantation Unit, Assiut University Urology Hospital. Adult patients who underwent or will undergo living donor kidney transplantation from November 2015 onward are assigned to one of two exposure groups based on the arterial suturing pattern chosen by the operating surgeon, without protocol-driven randomization. Preoperative assessment follows national kidney transplantation guidelines and includes detailed history, physical examination, laboratory investigations, and multimodal imaging of donors and recipients. Intraoperative management is standardized regarding donor nephrectomy technique, transplant approach, vascular anastomosis sites, ureteroneocystostomy, ischemia time recording, and immunosuppressive regimen. Postoperative follow-up extends for at least three months, with serial clinical evaluations, renal function tests, Doppler ultrasound, and radiologic imaging when indicated to detect vascular complications and characterize graft function trajectories over time. The primary goal is to determine whether one suturing pattern is associated with more favorable ischemia metrics and hemodynamic parameters, thereby informing best practice for vascular anastomosis in living donor kidney transplantation.

Who can participate

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Adult patients undergoing living donor kidney transplantation at Assiut Kidney Transplantation Unit since November 2015

Exclusion criteria

Patients undergoing end-to-end arterial suturing with internal iliac artery
Patients with acute allograft rejection within the first post-transplant week
Patients with follow-up shorter than 3 months after transplantation
Patients with missing relevant preoperative or postoperative data
Patients refusing participation

Treatment and study plan

Primary outcomes

Cold Ischemia Time

Time frame: From donor graft perfusion to arterial de-clamping during the transplant operation (single intraoperative measurement).

Duration in minutes from the start of graft perfusion with cold preservation solution in the donor to arterial de-clamping in the recipient, compared between interrupted and continuous arterial suturing groups.
Early Graft Arterial Blood Flow (Resistive Index and Systolic Velocity)

Time frame: Within the first 3 months after transplantation (assessments at approximately 1 week, 1 month, and 3 months post-transplant).

Mean systolic blood flow velocity and resistive index of the transplanted kidney artery measured by Doppler ultrasound and compared between interrupted and continuous arterial suturing groups.

Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

Patterns Of End-To-Side Arterial Suturing To The Iliac Arteries In Living Donor Kidney Transplantation

Important dates

Study start: 2026
Primary completion: 2027
Study completion: 2027
First posted: Dec 10, 2025
Registry last updated: Dec 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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