title: Early outcomes of laparoscopic donor nephrectomy with multiple renal arteries.
abstract: OBJECTIVE
  We evaluated our experience with laparoscopic donor nephrectomy in patients with multiple renal arteries, comparing operative outcomes and early graft function with patients with a single renal artery.
  
  
  METHODS
  From January 2003 to February 2009, 130 patients underwent laparoscopic donor nephrectomy at our institution, 108 (83 %) with a single renal artery and 22 (17 %) with multiple arteries. Donor and recipient outcomes for single artery and multiple arteries allografts were compared.
  
  
  RESULTS
  The LDN operative time was similar between the single artery and multiple arteries groups (162 vs 163 min, respectively, p = 0.87). Allografts with multiple arteries had significantly longer warm ischemia time (3.9 vs 4.9 min, p = 0.05) and cold ischemia time (72 vs 94 min, p < 0.001) than those with single artery. The conversion rate was similar between single and multiple arteries groups (6 % vs 4.5 %, respectively, p = 0.7). Multiple arteries grafts had a non statistically significant higher rate of poor graft function when compared to single artery grafts (23 % vs 12 %, respectively, p = 0.18). Five patients in the single artery group (4.6 %) and one patient in the multiple arteries group (4.5 %) needed dialysis during the first postoperative week. Overall, recipient complication rates were similar between single and multiple arteries groups (12.9 % vs 18.1 %, respectively, p = 0.51).
  
  
  CONCLUSIONS
  Laparoscopic donor nephrectomy with multiple arteries was associated with a non statistically significant higher rate of poor early graft function. The procedure appears to be safe in patients with multiple arteries, with similar complications rates. Multiple arteries should not be a contraindication for laparoscopic donor nephrectomy.
authors.affiliation: Department of Urology, Cajuru Hospital, Catholic University and Department of Urology, Santa Casa Hospital, Curitiba, Brazil. fmeyer@onda.com.br
authors.forename: Fernando
authors.initials: F
authors.lastname: Meyer
authors.forename: Sandro A
authors.initials: SA
authors.lastname: Nichele
authors.forename: Ari
authors.initials: A
authors.lastname: Adamy
authors.forename: Luiz Sergio
authors.initials: LS
authors.lastname: Santos
authors.forename: Christiano
authors.initials: C
authors.lastname: Machado
mesh_terms: D000328:Adult; D005260:Female; D006085:Graft Survival; 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*; D061646:Operative Time; D011183:Postoperative Complications; D012077:Renal Artery / Q000637:transplantation*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D016896:Treatment Outcome