Outcome of renal transplantation with multiple versus single renal arteries after laparoscopic live donor nephrectomy: a comparative study.
OBJECTIVE
To compare donor morbidity and recipient outcomes in patients with a single artery versus multiple arteries undergoing laparoscopic donor nephrectomy.


METHODS
A total of 303 consecutive laparoscopic donor nephrectomies were performed. Data from the group with multiple arteries (n = 27) (group I) were compared with those from the groups with single renal artery (n = 245) (group IIA) and early branching renal artery resulting in two artery recipient anastomoses (n = 31) (group IIB), in terms of donor and recipient outcomes.


RESULTS
Laparoscopic donor nephrectomy was technically successful in all 303 patients without need for open conversion. The graft retrieval time was higher in group I and group IIB compared with group IIA (3.9 +/- 1.4 and 3.9 +/- 0.8 versus 3.5 +/- 1.0 minutes). Similarly, warm ischemia time was significantly higher in groups I and IIB versus group IIA (7.2 +/- 1.9 and 6.7 +/- 1.9 versus 5.6 +/- 1.8 minutes). Creatinine level at day 1 was higher in group I compared with group IIA (2.4 +/- 1.4 versus 1.9 +/- 0.7 mg/dL). However, there was no significant difference in creatinine levels at 1 month and 1 year among the three groups. Overall graft survival in groups I, IIA, and IIB was 92%, 94.4%, and 94%, respectively.


CONCLUSIONS
Laparoscopic donor nephrectomy in the presence of multiple renal arteries is feasible and safe. Additionally, long-term graft survival and graft function at 1 month and 1 year are not adversely impacted by the presence of multiple renal arteries in grafts procured laparoscopically.
Desai
Mahesh R
MR
Department of Urology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India. mrdesai@mpuh.org
Ganpule
Arvind P
AP
Gupta
Rahul
R
Thimmegowda
Manohar
M
D000328:Adult; D015331:Cohort Studies; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012077:Renal Artery / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods
D003404:Creatinine