Early outcomes of laparoscopic donor nephrectomy with multiple renal arteries

Abstract

ARTIcLE INFO _________________________________________________________ ___________________Purpose: We evaluated our experience with laparoscopic donor nephrectomy in patients with multiple renal arteries, comparing operative outcomes and early graft function with patients with a single renal artery. Materials and Methods:From January 2003 to February 2009, 130 patients underwent laparoscopic donor nephrectomy at our institution, 108 (83%) with a single renal artery and 22 (17%) with multiple arteries. Donor and recipient outcomes for single artery and multiple arteries allografts were compared. Results: The LDN operative time was similar between the single artery and multiple arteries groups (162 vs 163 min, respectively, p = 0.87). Allografts with multiple arteries had significantly longer warm ischemia time (3.9 vs 4.9 min, p = 0.05) and cold ischemia time (72 vs 94 min, p < 0.001) than those with single artery. The conversion rate was similar between single and multiple arteries groups (6% vs 4.5%, respectively, p = 0.7). Multiple arteries grafts had a non statistically significant higher rate of poor graft function when compared to single artery grafts (23% vs 12%, respectively, p = 0.18). Five patients in the single artery group (4.6%) and one patient in the multiple arteries group (4.5%) needed dialysis during the first postoperative week. Overall, recipient complication rates were similar between single and multiple arteries groups (12.9% vs 18.1%, respectively, p = 0.51). Conclusion: Laparoscopic donor nephrectomy with multiple arteries was associated with a non statistically significant higher rate of poor early graft function. The procedure appears to be safe in patients with multiple arteries, with similar complications rates. Multiple arteries should not be a contraindication for laparoscopic donor nephrectomy.

Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels

“…[ 2 9 ] When looking at vascular complications in studies that have included only LLDN, an increased incidence is not reported. [ 3 5 13 14 17 20 21 29 ] This is comparable to our study; out of six vascular complications, the majority of which were hemorrhagic, only two arterial stenoses were observed, both of which were in the SRA group. We did not report any arterial stenosis or thrombosis in the MRA group and there was no significant difference in vascular complications between MRA and SRA grafts.…”

“…Comparable 1-year graft survival rates in recipients have been reported when comparing MRA and SRA grafts procured by LLDN. [ 3 5 6 13 14 17 20 21 29 ] We also report good 1-year and long-term graft survival rates in MRA grafts with no statistically significant difference to SRA grafts.…”

Outcome of Live Related Kidney Transplants with Multiple Renal Arteries

“…They concluded that the two groups had almost similar WIT but an increased CIT in MRA group. Meyer, et al [21] studied 130 patients with 108 SRA donors and 22 MRA donors. They reported higher WIT and CIT in MRA group.…”