title: How safe and effective is routine left hand-assisted laparoscopic donor nephrectomy with multiple renal arteries? A high-volume, single-center experience.
abstract: BACKGROUND
  We investigated the safety and effectiveness of routine harvest of the left kidney for renal transplantation regardless of the presence of multiple renal arteries to obtain the longer renal vein.
  
  
  METHODS
  Between February 2000 and July 2008, 325 patients underwent left hand-assisted laparoscopic living donor nephrectomy. The true renal arterial anatomy as evaluated intraoperatively was compared with the renal arterial anatomy by computed tomography (CT). We compared the results for the patients with a single renal artery (group I) with the patients with multiple renal arteries (group II) in terms of the donor and recipient outcomes.
  
  
  RESULTS
  Multiple renal arteries in left kidney were identified in 86 patients (26.5%). Thirty-seven CTs (11.4%) were in discord with the renal arterial anatomy evaluated intraoperatively. There was no difference in age, gender, body mass index, estimated blood loss, complication rate, or length of hospital stay between the 2 groups in the donor. Although the warm ischemic time and the operation time were significantly longer in group II (P = .008 and .001), overall graft survival was similar between the groups.
  
  
  CONCLUSIONS
  Routine harvest of the left kidney can be performed safely and effectively for the donor and recipient, even in the presence of multiple renal arteries.
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Cho
authors.forename: J Y
authors.initials: JY
authors.lastname: Lee
authors.forename: J C
authors.initials: JC
authors.lastname: Kim
authors.forename: S W
authors.initials: SW
authors.lastname: Kim
authors.forename: T-K
authors.initials: TK
authors.lastname: Hwang
authors.forename: S-H
authors.initials: SH
authors.lastname: Hong
mesh_terms: D000328:Adult; D005260:Female; D006085:Graft Survival; D058733:Hand-Assisted Laparoscopy / Q000009:adverse effects; D061847:Hospitals, High-Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000098:blood supply* / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D012077:Renal Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D052096:Warm Ischemia