title: A Novel Assessment of Vascular Regions Using an Intraoperative Near-Infrared Fluorescence.
abstract: BACKGROUND
  The risk of complications and transplant renal function increases in multiple arterial renal transplantations compared with single arterial renal transplantations. Even when multiple arteries are involved, with the introduction of laparoscopic nephrectomy, I mainly choose the left side kidney. Therefore, the number of renal artery reconstructions is increasing, and simultaneous imaging of arterial rebuilding during the donor nephrectomy is important.
  
  
  METHODS
  Between 2006 and 2015, we performed 132 living donor kidney transplantations at our center and analyzed 32 cases that were diagnosed pre- and intraoperatively.
  
  
  METHODS
  We compared the single renal artery (SRA) and multiple renal arteries (MRA) groups and analyzed the number of renal arteries, reconstruction methods, donor and recipient ages, sex, total ischemic times, and 1-month serum creatinine values.
  
  
  RESULTS
  In the MRA and SRA groups, the average recipient age was 52.3 and 47.0 years, respectively, while the average donor age was 52.9 and 53.1 years, respectively. In SRA and MRA groups, total ischemic time (TIT) was 96.1 and 143.6 min (P < .01). Serum creatinine level 1 month post-transplantation was 1.54 and 1.25, respectively (P < .001). Here we experienced 12 cases of living renal donor nephrectomy with multiple vessels in which the vascular supply territory was first assessed in April 2013 using an intraoperative near-infrared fluorescence camera system. In addition, regarding TIT, it is possible to shorten surgery by using individual anastomosis and ligation.
  
  
  CONCLUSIONS
  By managing multiple donors; arteries by nephrectomy, it is possible to improve kidney transplantation results.
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan. Electronic address: yn70@tokyo-med.ac.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kihara
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iwamoto
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ozawa
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sano
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Konno
authors.affiliation: Division of Acute and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ueno
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kawachi
mesh_terms: D000328:Adult; D005260:Female; D005453:Fluorescence; D006801:Humans; D007259:Infrared Rays; D007430:Intraoperative Care / Q000379:methods*; D007668:Kidney / Q000098:blood supply; D007674:Kidney Diseases / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome