Right renal vein

Figure 47-1 i The portal-venous system. HY, Hepatic vein IVC, inferior vena cava IMV, inferior mesenteric vein LGV, left gastric vein LRV, left renal vein PV, porta vein RRV, right renal vein ... 

Variant anatomy of the ovarian arteries includes the gonadal artery originating from the renal artery in about 20% of individuals [2]. Very rarely the artery arises from the adrenal, lumbar, or iliac arteries [2]. In some cases, the right ovarian artery passes behind the cava and over the right renal vein. The left ovarian artery will occasionally also pass over the left renal vein [2], There is very rarely a common trunk of left and right gonadal arteries, and occasionally there are multiple gonadal arteries. 

Inability to locate or cannulate the right ovarian vein is the most common reason for technical failure. The right ovarian vein origin is more variable in location than the left. It is usually located immediately anterior and inferior to the right renal vein orifice. The author s approach is to perform a right renal venogram to insure that the ovarian vein does not arise from the renal vein, and assess for accessory renal veins. I then withdraw the catheter to the... 

Fig. 24.8. Right renal vein tumor thrombosis associated to Wilms tumor (M). US shows an enlargement of the renal vein (arrowheads) filled with echogenic material...

In situ rat kidney perfusion experiments were carried out as described in Ref. [5.4]. Briefly, the perfusion medium used was Krebs-Henseleit buffer at pH7.4 containing glucose (5.6 mmol/L), 5.5% bovine serum albumin (fraction V, Sigma), 5-6% washed rat erythrocytes and different amino acids. After cannulation of the ureter and the renal vein and artery, the right kidney was perfused via the renal artery at a constant arterial pressure of 14.5 kPa at 37"C. After an equilibration period of 30-35 min, the agent was added and the perfusion continued for 60 min. Urine samples were collected every 10 min, and midpoint samples of the perfusate were also obtained. Inuhn was used as the standard for the measurement of the glomerular filtration rate. Elimination parameters of labelled peptides in the perfused rat kidney were characterized by the values of total renal clearance (CLr) and free fraction of the peptide in the perfusate (FJ. These values were compared with the glomerular filtration rate (GFR). 

A catheter, usually a Cobra catheter is introduced into the right femoral vein and directed into the peripheral left renal vein. Selective ovarian venog-... 

Fig. 17.12a,b. ovarian vein thrombosis. CT scans at the level below the renal hilum (a) and lower lumbar region (b). In a patient with bony metastasizing breast cancer (m), a nonoccluding thrombus (arrow) is identified within the dilated right ovarian vein (b). At the level just below the renal hilum, the renal vein (arrowhead) is patent (a)... 

Fig. 3.3a,b. Use of coronal reformatted images to aid in diagnosis, a Axial image shows edematous recently transplanted kidney (arrow). Renal vasculature was difficult to assess, b Coronal reformatted image shows renal artery (arrow) (left) and diminutive but patent renal vein (arrow) (right)... 

Fig. 20.16. A 2 -month-old boy after renal vein thrombosis. Sonogram of right kidney showing cortical nephrocalcinosis...

The most relevant information is the vascular extension through the renal vein (Fig. 24.8) and I VC (Fig. 24.9), occurring in 5-10% of cases. Patency of the renal vein is preferably assessed with Doppler imaging, whereas IVC thromboses are usually obvious on 2D US. The superior limit of the thrombus should be noted, and the status of the hepatic veins and the right atrium must systematically be checked in search of intravascular or intracardiac propagation. 

Fig.7.3a,b. A 53-year-old man after simultaneous pancreas-kidney transplantation. (CIA Common iliac artery, d donor s, ElA external iliac artery, llA internal iliac artery, IPDA inferior pancreaticoduodenal artery, r right, RA renal artery, RV renal vein, SA splenic artery, SMA superior mesenteric artery), a Angiogram obtained 31 months after operation shows normal posttransplant arterial anatomy with right-sided pancreatic and left-sided renal graft, b Maximum-intensity-projection reconstruction of contrast-enhanced MR imaging obtained 47 months after operation with normal posttransplant arterial anatomy... 

Fig. 7.6. A 28-year-old man image obtained 3 weeks after simultaneous pancreas-kidney transplantation with systemic venous drainage. 3D volumerendering display of contrast-enhanced MDCT during dominant venous phase shows normal posttransplant venous anatomy. (CIV Common iliac vein, d donor s, IVC inferior vena cava, PV portal vein, r right, RV renal vein.) Annotations pancreatic graft (arrow), renal graft (black asterisk)...

The donor kidney is usually placed extraperitoneaUy in the right or left iliac fossa. Anastomoses are constructed joining the transplant renal artery and vein to the recipient s respective iliac vessels. The ureter is joined to the bladder. The recipient native kidneys are left in situ in the majority of cases. 

Prior induction of heme oxygenase-1 with l-buthionine-(S,lt)-sulphoximine (2mmol/kg body weight) 5 h before the occlusion of the left renal artery and vein for 45 min ameliorated the ischaemic injury induced in male Wistar rats 3 weeks after the removal of their right kidney (Horikawa et al. 2002). 

Figure 4 (A) Chest radiograph of a patient with MPO-ANCA vasculitis who presented with pulmonary hemorrhage and renal failure, demonstrating diffuse alveolar shadowing. Additionally, a central venous dialysis catheter is visible in the right internal jugular vein. (B) CT scan of a patient with pulmonary fihrosis diagnosed concurrently with their renal failure due to MPO-ANCA-associated vasculitis, demonstrating the characteristic hon-eycomhing pattern.

Fig. ll.lla,b. Dynamic liver MDCT in a patient with severe right-sided cardiac failure and renal insufficiency, a Intense reflow of the iodinated contrast agent within the hepatic veins is seen shortly after the i.v. injection in the arm vein, with severe delay of aortic enhancement, b Mottled appearance of the liver parenchyma in the later phase of liver enhancement due to stagnation of iodinated contrast material within hepatic sinusoids. There is a hypodense area on the splenic parenchyma corresponding to a local infarction... 

Fig. 7.14a,b. A 43-year-old woman with abdominal discomfort image obtained 12 days after simultaneous pancreas-kidney transplantation, a, b Contrast-enhanced multidetector CT displays acute thrombosis of superior mesenteric vein (arrowheads) and splenic vein (arrowhead) but homogeneous contrast enhancement of pancreatic graft (arrow) with donor s duodenum (arrows) and renal graft (asterisk). (CIA common iliac artery, CIV common iliac vein, d donor s, IPDA inferior pancreaticoduodenal artery, / left, r right, SA splenic artery, SMA superior mesenteric artery)... 

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