title: When one becomes more: minimum renal artery length in laparoscopic live donor nephrectomy.
abstract: BACKGROUND
  Laparoscopic donor nephrectomy may convert short main arteries into multiple arteries, increasing the technical challenge of implantation. We evaluated our experience to identify factors predictive of multiple arteries after laparoscopic nephrectomy.
  
  
  METHODS
  All laparoscopic nephrectomies from the start of our program in November 2002 until June 2013 were studied, and preoperative imaging reviewed for donor artery length and multiplicity together with operative findings.
  
  
  RESULTS
  A total of 287 consecutive laparoscopic live donor nephrectomies (64 right and 223 left nephrectomies) were studied. Renal artery length was measured from preoperative donor magnetic resonance or computed tomography angiogram and nephrectomy performed using a laparoscopic stapling device. Nine left kidneys with a single artery (6, 7, 9, 10, 11, 12, 13, 14, and 16 mm in length) and five right kidneys with a single artery (5, 13, 15, 20, and 26 mm) on imaging resulted in multiple renal arteries at implantation. Complex renal vein anatomy was associated with multiple arteries following retrieval.
  
  
  CONCLUSIONS
  A main renal artery length of more than 16 mm on the left and 26 mm on the right is unlikely to result in multiple arteries to implant. The possibility of multiple arteries should be borne in mind when the donor renal artery is short.
authors.affiliation: University of Cambridge, Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
authors.forename: S
authors.initials: S
authors.lastname: Iype
authors.affiliation: University of Cambridge, Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: S
authors.initials: S
authors.lastname: David
authors.affiliation: University of Cambridge, Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hilliard
authors.affiliation: University of Cambridge, Department of Radiology, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: A
authors.initials: A
authors.lastname: Shaw
authors.affiliation: University of Cambridge, Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
authors.forename: N V
authors.initials: NV
authors.lastname: Jamieson
authors.affiliation: University of Cambridge, Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
authors.forename: R K
authors.initials: RK
authors.lastname: Praseedom
authors.affiliation: University of Cambridge, Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Butler
authors.affiliation: University of Cambridge, Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
authors.forename: E L
authors.initials: EL
authors.lastname: Huguet
authors.affiliation: Health Services Research Unit, University of Edinburgh, Edinburgh, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Parker
authors.affiliation: University of Cambridge, Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Bradley
authors.affiliation: University of Cambridge, Department of Surgery, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Comprehensive Biomedical Research Centre, Cambridge, UK.
authors.forename: C J E
authors.initials: CJ
authors.lastname: Watson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011379:Prognosis; D012077:Renal Artery / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D055815:Young Adult
keywords: artery length; living donor kidney transplantation; magnetic resonance angiography; multiple renal arteries; renal artery