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

November 28, 2025 updated by: Aly Adel Abdelhamid Ahmed Elyounsy, Assiut University

Patterns Of End-To-Side Arterial Suturing To The Iliac Arteries 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.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

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.

Study Type

Observational

Enrollment (Estimated)

70

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Probability Sample

Study Population

The study includes adult recipients of living donor kidney transplants performed at Assiut University Urology Hospital. Patients are selected based on having undergone or scheduled for living donor kidney transplantation, excluding those with end-to-end arterial suturing with the internal iliac artery, early acute rejection, or inadequate follow-up or data. Both retrospective cases and prospectively recruited patients with complete clinical, radiological, and laboratory data are included. The sample size is 70 patients divided equally between two arterial suturing technique groups.

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Interrupted Arterial Suturing
Adult living donor kidney transplant recipients whose renal artery is anastomosed end-to-side to the external or common iliac artery using interrupted 6/0 Prolene sutures as part of standard surgical practice.
Continuous Arterial Suturing
Adult living donor kidney transplant recipients whose renal artery is anastomosed end-to-side to the external or common iliac artery using continuous 6/0 Prolene sutures as part of standard surgical practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
From donor graft perfusion to arterial de-clamping during the transplant operation (single intraoperative measurement).
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.
Within the first 3 months after transplantation (assessments at approximately 1 week, 1 month, and 3 months post-transplant).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 1, 2026

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

February 1, 2027

Study Registration Dates

First Submitted

November 28, 2025

First Submitted That Met QC Criteria

November 28, 2025

First Posted (Actual)

December 10, 2025

Study Record Updates

Last Update Posted (Actual)

December 10, 2025

Last Update Submitted That Met QC Criteria

November 28, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Arterial suturing in kidney

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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