Impact of renal artery multiplicity on outcomes of renal donors and recipients in laparoscopic donor nephrectomy

• Published in: Urology (Ridgewood, N.J.) Vol. 61; no. 2; pp. 323 - 327
• Main Authors: Hsu, Thomas H.S, Su, L.i-Ming, Ratner, Lloyd E, Trock, Bruce J, Kavoussi, Louis R
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2003; Elsevier Science
• Subjects: Adolescent; Adult; Age Factors; Aged; Biological and medical sciences; Child; Child, Preschool; Female; Humans; Kidney - blood supply; Kidney Transplantation - methods; Laparoscopy - methods; Living Donors; Male; Medical sciences; Middle Aged; Nephrectomy - methods; Renal Artery - abnormalities; Renal Artery - surgery; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue and Organ Harvesting - methods; Treatment Outcome; Urologic Surgical Procedures - methods; Human; Kidney disease; Urinary system disease; Renal artery; Transplantation; Laparoscopy; Homotransplantation; Kidney; Treatment; Donor; Nephrectomy; Surgery; Renal failure; Adult; Endoscopy; Technique
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(02)02124-6

To review our laparoscopic donor nephrectomy experience to determine the impact of multiple renal arteries on renal donor and recipient outcomes. Multiple renal arteries can present a challenge during live laparoscopic donor nephrectomy. During a 6-year period, 353 patients underwent laparoscopic donor nephrectomy and an equal number of patients underwent living-related renal transplantation. A retrospective chart review was performed to evaluate the renal donors and recipients associated with the laparoscopic procedure. Laparoscopic donor nephrectomies were associated with one renal artery in 277 cases (78.5%), two renal arteries in 71 cases (20.1%), and three renal arteries in 5 cases (1.4%). A left-sided procedure was most commonly performed in all three groups. The operative and renal allograft warm ischemia times increased with the number of renal arteries, but the differences were not statistically significant. The renal artery anatomy did not have a significant association with intraoperative blood loss, postoperative hospital stay, or complication rate in the donor group. Regarding the transplant recipients, renal artery multiplicity had no significant association with the complication rate, 1-year graft survival, or creatinine clearance levels at 1, 2, or 3 days or at 3, 6, or 12 months postoperatively. With meticulous procurement and reconstructive transplantation techniques, the presence of multiple renal arteries in laparoscopic donor nephrectomy does not have a significant impact on the outcomes of the renal donors or recipients.