title: Impact of renal artery multiplicity on outcomes of renal donors and recipients in laparoscopic donor nephrectomy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.
authors.forename: Thomas H S
authors.initials: TH
authors.lastname: Hsu
authors.forename: L i-Ming
authors.initials: Li
authors.lastname: Su
authors.forename: Lloyd E
authors.initials: LE
authors.lastname: Ratner
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Trock
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012077:Renal Artery / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods*