title: Laparoscopic donor nephrectomy in unusual venous anatomy - donor and recepient implications.
abstract: OBJECTIVE
  Laparoscopic donor nephrectomy is now a commonly performed procedure in most of renal transplantation centers. However, the suitability of laparoscopy for donors with abnormal venous anatomy is still a subject of debate.
  
  
  METHODS
  Between August 2007 and August 2014, 243 laparoscopic donor nephrectomies were performed in our institution. All donors were evaluated with preoperative three-dimensional spiral computed tomography (CT) angiography Thirteen (5.35%) donors had a left renal vein anomaly. A retrospective analysis was performed to collect donor and recipient demographics and perioperative data.
  
  
  RESULTS
  Four donors had a type I retroaortic vein, seven had type II retroaortic vein and a circumaortic vein was seen in three donors. The mean operative time was 114±11 minutes and mean warm ischemia time was 202±12 seconds. The mean blood loss was 52.7±18.4mL and no donor required blood transfusion. Mean recipient creatinine at the time of discharge was 1.15±0.18mg/dL, and creatinine at six months and one year follow-up was 1.12±0.13mg/dL and 1.2±0.14mg/dL, respectively. There were no significant differences in operative time, blood loss, warm ischemia time, donor hospital stay or recipient creatinine at 6 months follow-up, following laparoscopic donor nephrectomy in patients with or without left renal vein anomalies.
  
  
  CONCLUSIONS
  Preoperative delineation of venous anatomy using CT angiography is as important as arterial anatomy. Laparoscopic donor nephrectomy is safe and feasible in patients with retroaortic or circumaortic renal vein with good recipient outcome.
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bangalore.
authors.forename: Avinash Bapusaheb
authors.initials: AB
authors.lastname: Patil
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bangalore.
authors.forename: Tarun Dilip
authors.initials: TD
authors.lastname: Javali
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bangalore.
authors.forename: Harohalli K
authors.initials: HK
authors.lastname: Nagaraj
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bangalore.
authors.forename: S M L Prakash
authors.initials: SMLP
authors.lastname: Babu
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bangalore.
authors.forename: Arvind
authors.initials: A
authors.lastname: Nayak
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D012082:Renal Veins / Q000002:abnormalities / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D052096:Warm Ischemia
chemical_list: D003404:Creatinine
keywords: Kidney Transplantation; Laparoscopy; Veins