Anatomical study of the renal veins observed during 342 living-donor nephrectomies

Abstract

The anatomical variations of renal veins observed during 342 nephrectomies in living donors are described, 311 cases on the left side and 31 on the right. The following anatomy of the renocava veins was observed: 1. On the left side the renal vein was always unique (311/311) and had two tributaries (suprarenal and gonadal veins) in 100 per cent and one or more renolumbar veins in 65.27 per cent, encircling the aorta in 1.07 per cent, was retroaortic in 1.4 per cent; and the inferior vena cava was double in 0.64 per cent; B-on the right side the renal vein was double in 29 per cent (9/31) and had only one tributary (gonadal vein) in one case, for 3.22 per cent (1/ 31); three or more renal veins in 9.7 per cent (3/31). We concluded that the left renal vein is always unique, presenting variations principally in its tributaries and trajectory. On the right side, the renal vein was double or triple in 38.79 per cent UNITERMS: Nephrectomies. Renal veins. Kidney transplantation. INTROOUCTION It is crucial to know the anatomy of the renal vessels during a retroperitoneal approach to prevent bleeding by accidental tearing. I Comparably, the renal venous pattem of the right side bears little resemblance to that of the left. In its relatively short course from the kidney to the inferior vena cava, the right vein rarely receives a tributary. The longer left renal vein (LRV), on the contrary, regularly receives the following tributaries: suprarenal and inferior phrenic, from above, frequently joined; gonadal (testicular or ovarian) from below; and renolumbar vein posteriorly, often by a confluent with the gonadal vein. ,3Address for correspondence:José Carlos Costa Baptista-Silva Rua Prot. Artur Ramos, 178, 123-Vega São Paulo/SP -Brasil-CEP 01454-904 During the living donor nephrectomy, the left kidney is used more often as a donor organ because its vein is longer than the right renal vein. Usually, the LRV anteriorly crosses the aorta before reaching the vena cava. MATERIAL ANO METHOOSFrom May 1990 to May 1996, 342 living-donor nephretomies (311 on the left side and 31 on the right) were performed at Dom Silvério Gomes Pimenta (260) and Beneficência Portuguesa (82) HospitaIs. Of the 342, 208 cases were female and 134 male, 85 per cent were white, an~the average age was 43.8 years. All cases were studied through preoperative renal angiography and intraoperative observation.

Double right renal vein: clinical and surgical implications and review of the literature

“…An error of fusion of these two vessels, thus causing their persistence, may result in bilateral or unilateral duplication of these vessels [10]. Occurrences of multiple renal veins are relatively common, and several authors have reported large numbers of venous variations resulting from embryonic developmental errors [1], [5], [11][12][13]. According to Kaneko, Kobayashi and Okada [14], the renal veins present fewer variations than do the renal arteries, and multiple renal veins are more common on the right side than on the left-sid [8].…”

“…Because the right kidney is closer to the interior vena cava, the right renal vein is generally shorter and rarely receives tributaries. On the other hand, the left renal vein, which is longer, may receive several tributaries [1], [2]. Variations in the origin, path and termination of the renal veins, along with vascular malformations that are found in the renal hilum involving both arteries and veins, result mainly from errors of embryonic development [3], [4].…”

“…Several vascular anatomical variations in the renal hilum have been studied. The appearance of supernumerary vessels is the variation most frequently encountered among the renal morphological variations [1], [2], [5][6][7][8]. Knowledge of these variations, along with any other variations, is clinically important, because it allows surgeons to make better preoperative evaluations and thus minimize the risk of surgical complications [9].…”

Triple Right Renal Vein: An Uncommon Variation

“…It describes a horizontal course toward the inferior vena cava, in which it drains. In literature, a significant prevalence of anatomical variations on the left renal vein (about 92%) was found (Baptista-Silva et al, 1997), and the presence of multiple right renal veins (more than 2 vessels) was found in about 8,0 to 9,7% of cases (Baptista-Silva et al). On the other hand, Bergman et al, pointed that, the renal veins show less variation than do the renal arteries and multiple renal veins to be rare on the left side (1%) and common on the right side (28%).…”

Renal Vein Reconstruction for Harvesting Injury in Kidney Transplantation

“…Bu sorunlar genellikle greft nefrektomi veya nakli sıra-sında travma ile ilgilidir. Güçlüklerin sağ böbrek ile ortaya çık-ması, sağ renal venin daha kısa ve anatomik varyasyonlarının sol tarafa göre daha sık olmasından dolayı daha olasıdır [2,5]. Bizim olgumuzda da, donör sağ renal venin yaralanmış olmasın-dan dolayı teknik zorlukla karşılaştık.…”