title: Recipient outcomes of dual and multiple renal arteries following 1000 consecutive laparoscopic donor nephrectomies at a single institution.
abstract: OBJECTIVE
  We examined outcomes of kidney transplant recipients from allografts harvested via laparoscopic donor nephrectomy (LDN) with various arterial anatomies. We examined the risk of slow graft function, delayed graft function (DGF), and postoperative urological complications in recipients of multi-vessel allografts.
  
  
  METHODS
  Donor and recipient records for 1000 consecutive LDN were reviewed (1996-2005). Characteristics examined included donor demographics, intraoperative parameters and complications, recipient post-operative complications and short-term recipient allograft function.
  
  
  RESULTS
  DGF was 5.3% for single; 5.2% for dual; and 9.8% for multiple (p = 0.05). Recipient creatinine (Cr) at one wk and one month was 1.9 + 1.5 and 1.6 + 0.8; 2.1 + 1.6 and 1.7 + 1.2; 2.8 + 2.3 and 1.7 + 0.8 respectively (p = 0.01). Recipient Cr at one year averaged 1.6 mg % with no significant differences between groups, with 48 ureteral complications (4.8%): 32/732 = 4.4% recognized in single arterial allograft recipients; 12/212(5.7%) for dual and 4/43 for multiple (9.3%) (p = 0.03).
  
  
  CONCLUSIONS
  Complex vascular anatomy not a contraindication to LDN. Recipients of allograft with >2 arteries experience longer warm and cold ischemia times, greater incidence of DGF, and greater propensity for ureteral complications. Long term recipient outcomes remain excellent.
authors.affiliation: Division of Transplantation, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA. mcooper@smail.umaryland.edu
authors.forename: Matthew
authors.initials: M
authors.lastname: Cooper
authors.forename: Andrew
authors.initials: A
authors.lastname: Kramer
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Nogueira
authors.forename: Michael
authors.initials: M
authors.lastname: Phelan
mesh_terms: D000328:Adult; D051799:Delayed Graft Function / Q000209:etiology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology; D012077:Renal Artery / Q000033:anatomy & histology*; D012189:Retrospective Studies; D012307:Risk Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D019737:Transplants; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000209:etiology