Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the curative effect and safety of artificial expanded polytetrafluorethylene (ePTFE) protective external vascular sheath for kinked transplanted renal artery.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 286 kidney transplants were performed between January 2019 and June 2022 at the First Affiliated Hospital of Soochow University, of which 8 cases presented with excessive anastomotic artery length and arterial kinking after placement in the iliac fossa, affecting the blood supply of transplanted kidney. An artificial ePTFE external vascular sheath was then used to wrap and immobilize the anastomotic artery during the operation. Demographics, preoperative, and postoperative recovery data of those patients were retrospectively analyzed, and the efficacy and safety of the method were evaluated.
Ｒｅｓｕｌｔｓ：Among the 8 patients, 6 were male and 2 were female, with an average age of 43.1±8.5 years. All 8 cases had a kinked anastomotic artery when the right donor kidney with a single branch artery was anastomosed end-to-end with the recipient internal iliac artery. Two cases exhibited a weakened pulsation of transplant kidney and a darkening of its color immediately after the kidney was placed in the right iliac fossa. No deterioration of color or tension was found in the remaining 6 cases. The application of an artificial ePTFE external vascular sheath significantly corrected the kinked artery and improved blood supply of the transplanted kidney. Postoperative ultrasonography showed that the arterial velocity was 146.7±10.4 cm／s, and the resistance index (RI) was 0.68±0.06. All of the patients recovered normally after surgery except for one case that developed delayed graft function (DGF), with a gradual increase in urine output on the fifth postoperative day and a return to normal renal function in the second week. No rejection, arterial thrombosis, or infection occurred, and no abnormalities were observed under the ultrasound or CT. The flow velocity and RI in the third month after the operation were 151.3±7.8 cm／s and 0.67±0.07, respectively. There were no significant differences compared to the immediate postoperative data (P>005). All 8 cases survived without any manifestations of renal artery stenosis, infection and discomfort in the surgical area.
Ｃｏｎｃｌｕｓｉｏｎ：The ePTFE protective external sheath effectively corrected the kinked anastomotic artery, improved the blood supply, and reduced the possibility of longterm stenosis in the transplanted renal artery. It demonstrated good stability, high safety and few complications.

Key words: renal transplantation, renal artery kinking, vascular graft