title: Renovascular complications of laparoscopic donor nephrectomy.
abstract: OBJECTIVE
  To review the operative renovascular injuries related to our laparoscopic donor nephrectomy experience, since management of intraoperative renovascular complications during laparoscopic nephrectomy can present a serious challenge.
  
  
  METHODS
  During a 6-year period, 353 patients underwent laparoscopic donor nephrectomy. A retrospective chart review was performed to identify and evaluate the renovascular complications associated with the procedure.
  
  
  RESULTS
  Eight cases (2.3%) of renovascular complications were identified. Vascular injury involved the renal artery in 6 cases and the renal vein in 2 cases. The etiologies included endovascular GIA stapling failure (n = 2), surgical clip dislodgment (n = 2), and vessel laceration during dissection or stapling (n = 4). Open conversion was necessary in 6 cases (75%). No patient mortality or allograft loss occurred.
  
  
  CONCLUSIONS
  Laparoscopic donor nephrectomy is associated with a low incidence of renovascular complications. Laparoscopic or open surgical management may be required when problems arise to optimize donor safety and allograft survival.
authors.affiliation: Brady Urological Institute and Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.
authors.forename: Thomas H S
authors.initials: TH
authors.lastname: Hsu
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Su
authors.forename: Lloyd E
authors.initials: LE
authors.lastname: Ratner
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
mesh_terms: D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy; D012077:Renal Artery / Q000293:injuries*; D012082:Renal Veins / Q000293:injuries*; D012189:Retrospective Studies