Donor nephrectomy with and without preservation of gonadal vein while dissecting the ureter.
BACKGROUND
Preservation of the gonadal vein while dissecting the ureter for donor nephrectomy may decrease the distal ureteral ischemia and urological complications in kidney transplant recipients. In this study, we compared the outcome of kidney allografts harvested with preservation of the gonadal vein while dissecting the ureter with allografts harvested without preserving the gonadal vein.


METHODS
We reviewed 167 consecutive kidney transplantations between April 2003 and April 2004. During donor nephrectomy, we preserved the gonadal vein in 106 harvested kidneys (group 1), while we did not preserve this vein in 61 allografts (group 2). The recipients in each group were followed up for a 2-year follow-up on average, and the outcomes including ureteral complications, graft loss, and patient and graft survival were compared between the two groups.


RESULTS
Urine leakage was noted in few patients (2 in group 1 and 3 in group 2) and its frequency was not significantly different between the two groups (P = .26). Ureteral stricture was not seen in any of the kidney allograft recipients. No differences were found in the frequencies of acute rejection episodes, graft loss, and death between the two groups.


CONCLUSIONS
Preservation of the gonadal veins did not significantly decrease the frequency of ureteral complications in the kidney transplant recipients. We recommend meticulous handling of the ureter in donor nephrectomies to prevent further remote complications regardless of the approach to the gonadal veins while nephrectomy.
Aliasgari
Majid
M
Shahid Modarress Hospital, Shahid Beheshti University (MC), Tehran, Iran.
Shakhssalim
Nasser
N
Dadkhah
Farid
F
Ghadian
Alireza
A
Moghaddam
Seyyed Mohammadmehdi Hosseini
SM
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004210:Dissection / Q000379:methods*; D005260:Female; D006066:Gonads / Q000098:blood supply*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014515:Ureteral Diseases / Q000453:epidemiology*; D014680:Veins; D055815:Young Adult