title: Routine left robotic-assisted laparoscopic donor nephrectomy is safe and effective regardless of the presence of vascular anomalies.
abstract: The classic approach to donor nephrectomy consists of preferential procurement of the kidney without vascular anomalies. We studied the effect of routine procurement of the left kidney regardless the presence of multiple arteries on the outcomes of robotic-assisted laparoscopic living donor nephrectomy (LLDN) with particular reference to the incidence of urological complications. From August 2000 to July 2005, 209 left LLDNs were performed. We analyzed the outcomes of donors and recipients in relation to the presence of multiple vessels versus normal anatomy. We divided the patients into two groups: group A (n = 148) with normal vascular anatomy and group B (n = 61) with vascular anomalies. In the donors, no significant difference in conversion to open surgery rate, blood loss, length of stay, was noted between the two groups; operative time and warm ischemia time were slightly higher in group B. One-year patient survival was 98% in both groups while the 1-year graft survival was 96.6% in group A and 96% in group B. Only one urological complication was noted in the group with normal anatomy (0.7%) versus none in the group with multiple arteries. Left kidney procurement using robotic-assisted laparoscopic technique is safe and effective, even in the presence of vascular anomalies.
authors.affiliation: Division of General Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: Verónica
authors.initials: V
authors.lastname: Gorodner
authors.forename: Santiago
authors.initials: S
authors.lastname: Horgan
authors.forename: Carlos
authors.initials: C
authors.lastname: Galvani
authors.forename: Antonio
authors.initials: A
authors.lastname: Manzelli
authors.forename: José
authors.initials: J
authors.lastname: Oberholzer
authors.forename: Howard
authors.initials: H
authors.lastname: Sankary
authors.forename: Giuliano
authors.initials: G
authors.lastname: Testa
authors.forename: Enrico
authors.initials: E
authors.lastname: Benedetti
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D012077:Renal Artery / Q000002:abnormalities; D012082:Renal Veins / Q000002:abnormalities; D012371:Robotics / Q000379:methods*; D012449:Safety