Critical Analysis of Laparoscopic Donor Nephrectomy in the Setting of Complex Renal Vasculature: Initial Experience and Intermediate Outcomes

Disick, Grant; Shapiro, Michael; Miles, Ruth Ann; Munver, Ravi

doi:10.1089/end.2008.0242

Cited by 17 publications

(11 citation statements)

References 19 publications

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“…The most common renal venous anomaly is the occurrence of dual renal veins, accounting for 15%-30%, frequently on the right side 18,19,23,36 . In this case, the smaller tributary can often be ligated without significant consequence, whereas the larger vein should be preserved to maintain better venous drainage 37 . Anomalous veins are likely to be dilated and tortuous predisposing injury to occur during surgical dissection 38 .…”

Section: Multiple Renal Veins and Lumbar Veinsmentioning

confidence: 99%

Clinical importance of anatomical variations of renal vasculature during laparoscopic donor nephrectomy

He¹,

Hamdorf²

2013

OA Anatomy

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Introduction Laparoscopic live donor nephrectomy has become a well-accepted practice in most transplant units. However, the variations and complex of renal vasculature may make the surgery even more challenging during laparoscopic donor nephrectomy. The aims of this article are to review embryology of the renal vasculature development and the clinical significance of renal vasculature anomalies during laparoscopic donor nephrectomy and the consequence of kidney transplant. Discussion The results were interpreted and summarised as renal artery development and its anomalies and renal vein development and its anomalies including associated anomalies of the inferior vena cava. The clinical significance during laparoscopic donor nephrectomy was explored. The value of computed tomography angiography was emphasised during live donor work-up and before surgery planning. Conclusion It is paramount for surgeons to have a thorough knowledge of renal vasculature development and to readily identify the anomalies of renal vasculature on computed tomography angiography prior to laparoscopic donor nephrectomy. The adverse

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Section: Multiple Renal Veins and Lumbar Veinsmentioning

confidence: 99%

Clinical importance of anatomical variations of renal vasculature during laparoscopic donor nephrectomy

He¹,

Hamdorf²

2013

OA Anatomy

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“…Published research has listed the option to preferably choose a right donor kidney over a left in the presence of a retroaortic vein anomaly [12, 13]. Recent data from other authors suggest that choosing a left kidney with retroaortic vein is safe with good outcomes for donor and recipient [14-16].…”

Section: Discussionmentioning

confidence: 99%

Is a Retroaortic Vein a Risk Factor in Laparoscopic Living Donor Nephrectomy?

et al. 2020

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Introduction: In living donor transplantation choosing the right donor and donor side for laparoscopic donor nephrectomy is a challenging task in clinical practice. Knowledge about anomalies in renal blood supply are crucial to evaluate the feasibility of the operative procedure. Few data so far exist whether the existence of a retroaortic left renal vein has an impact on living kidney transplantation outcome for donor and recipient. Materials and Methods: We retrospectively analyzed 221 patients who underwent laparoscopic living donor nephrectomy between 2011 and 2017 for existence of a retroaortic left renal vein. Clinical characteristics and operative outcomes for donors and recipients were analyzed. Results: 221 patients underwent donor nephrectomy between 2011 and 2017; 11 patients (4.98%) showed the feature of a retroaortic left renal vein, and in 8 patients (72.7%) out of those 11 the left kidney was chosen for transplantation. Mean preoperative serum creatinine was 0.77 (0.49–0.98) mg/dL and 1.28 (0.97–1.64) mg/dL at discharge. In recipients mean serum creatinine preoperatively, after 1 week, 1 month,1 year, 2 and 3 years of follow-up was 10.36 (6.09–20.77) mg/dL, 1.71 (0.67–2.72), 1.33 (0.70–1.89), 1.31 (0.95–2.13), 1.31 (0.98–2.13) and 1.33 (1.03–1.84), respectively. Neither donors nor recipients suffered from any operative complications. Conclusions: Laparoscopic living donor nephrectomy of a left kidney with retroaortic renal vein is safe for the donor, without limitation in the outcome for the recipient.

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“…In one series[4] it was reported to be 7.7%. Since the arterial blood supply of the kidney is segmental, loss of arterial flow in the distribution of an accessory polar vessel can result in a significant area of infarction.…”

Section: Discussionmentioning

confidence: 99%

Donor gonadal vein reconstruction for extension of the transected renal vessels in living renal transplantation

et al. 2010

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Introduction:Donor gonadal vein is a readily available vascular reconstruction material for vascular reconstruction, for difficult situations, in living related renal transplantation. Vein extension with the gonadal vein has been described as a simple and safe method to elongate renal vein especially in right living donor kidneys. We applied the donor gonadal vein for lacerated accessory renal artery and renal vein reconstruction.Materials and Methods:The donor gonadal vein was used to reconstruct the lacerated accessory renal artery in one patient. The donor gonadal vein was isolated, used as an interposition graft to bridge the gap between transected accessory renal artery and external iliac artery of the recipient. In another patient, gonadal vein was used to reconstruct short right renal vein, which got damaged during retrieval.Results:This technique resulted in a tension-free anastomosis. There were no procedure related complications. The ischemia time remained within acceptable limits and grafts showed excellent outcomes.Conclusions:The use of gonadal vein for renal vascular reconstruction seems to be an acceptable option during living related renal transplantation, lest the need arise, with no increased graft morbidity.

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Critical Analysis of Laparoscopic Donor Nephrectomy in the Setting of Complex Renal Vasculature: Initial Experience and Intermediate Outcomes

Abstract: LDN in patients with complex vascular anatomy is safe and efficacious and does not negatively impact the complication rate or recipient outcomes. This procedure may improve the availability of allografts.

Cited by 17 publications

References 19 publications

Clinical importance of anatomical variations of renal vasculature during laparoscopic donor nephrectomy

Clinical importance of anatomical variations of renal vasculature during laparoscopic donor nephrectomy

Is a Retroaortic Vein a Risk Factor in Laparoscopic Living Donor Nephrectomy?

Donor gonadal vein reconstruction for extension of the transected renal vessels in living renal transplantation

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