title: Retroperitoneoscopic donor nephrectomy with multiple renal arteries does not affect graft survival and ureteral complications.
abstract: BACKGROUND
  Outcomes of retroperitoneoscopic procurement of living kidneys with multiple renal arteries (MRA) in the recipients are largely unknown. Our aim is to access the effect of kidney allografts with MRA on donor and recipient outcomes after pure retroperitoneoscopic live donor nephrectomy (RPLDN).
  
  
  METHODS
  From July 2001 to August 2010, 533 patients underwent live donor kidney transplants with allografts procured by RPLDN at our center. Of these 533 transplants, 406, 105, and 22 patients had one, two, and three renal arteries, respectively. We compared the retrospectively collected clinical data of each donor with MRA and the recipient using those with single renal artery as controls.
  
  
  RESULTS
  Significant differences were found among the one-renal artery and three-renal artery groups regarding operative time, estimated blood loss, warm and cold ischemic time, and incidence of slow graft function (SGF). However, there was no significant difference regarding patient and graft survival among the three groups. Major complications, such as open conversion, bleeding, and blood transfusion, were not found in patients with MRA. Five ureteral complications occurred. Of these, there was one patient with MRA. In univariate analysis, MRA patients had a risk factor of developing SGF (P=0.005) but not ureteral complications following RPLDN.
  
  
  CONCLUSIONS
  Kidneys with MRA after RPLDN increase the risk of SGF in recipients. However, they provide similar outcomes as to long-term graft survival and complications compared with those of single renal artery. Renal artery multiplicity should not be a contraindication for live kidney donation and may not increase the risk of ureteral complications.
authors: 1 Department of Urology, Tokyo Women's Medical University. 2 Address correspondence to: Kazuya Omoto, M.D., Ph.D., Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors: Kazuya
authors: K
authors: Omoto
authors: Taiji
authors: T
authors: Nozaki
authors: Masashi
authors: M
authors: Inui
authors: Toshihito
authors: T
authors: Hirai
authors: Yugo
authors: Y
authors: Sawada
authors: Tomokazu
authors: T
authors: Shimizu
authors: Daisuke
authors: D
authors: Toki
authors: Hideki
authors: H
authors: Ishida
authors: Kazunari
authors: K
authors: Tanabe
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012077:Renal Artery / Q000601:surgery*; D051437:Renal Insufficiency / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*