Hand Assisted Retroperitoneoscopic Donor Nephrectomy in Challenging Cases; Right Sided Donor Nephrectomy With Multiple Renal Arteries

E. Akin,¹ I. Barlas,¹ M. Dayangac,¹ A. Sinangil,² V. Celik,² T. Ecder.²

¹Kidney Transplantation, Istanbul Bilim University Florence Nightengale Hospital, Istanbul, Turkey
²Nephrology, Istanbul Bilim University Florence Nightengale Hospital, Istanbul, Turkey.

Meeting: 2015 American Transplant Congress

Abstract number: C151

Keywords: Donation, Kidney transplantation, Laparoscopy, Nephrectomy

Session Information

Session Name: Poster Session C: Living Donor Issues 2

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Hand-assisted retroperitoneoscopic (HARP) nephrectomy is a potentially safer approach for the donor where the peritoneum stays intact and tactile sensation remains. The experience with HARP in challenging cases are limited in literature. The purpose of this study is to evaluate the safety of HARP technique in cases with multiple arteries with special emphasis on right-sided kidneys.

HARP nephrectomy was performed to 418 donors at our series between February 2009 and June 2014. 18,6%(n=78) was right donor nephrectomy. The number of donors with multiple arteries and right nephrectomy was 11(14.1%) and left nephrectomy was 53(15.6%). There were three and more arteries in 2 cases at right and 4 at left side. There was one case with double ureter at right side and one case with two renal vein at the left side.

None of the donors had conversion to open DN, readmission or reoperation. The female/male ratio was 7/4 at right and 20/33 at left side.The mean of age and weight was similar in between the two groups. The mean dissection time(incision to complete dissection of the kidney) was 115 min for right and108 min for left.

Comparison of right and left donor nephrectomy
Right(n=11) / Left (n=53)	Mean Right / Left	Std. Deviation	Std. Error Mean	P value
Donor age	48,91/42,75	14,377 /12,539	4,335 /1,722	0,2
Donor BW (kg.)	78,09 /73,57	15,300 /11,265	4,613/1,547	0,3
Dissection time /min.)	115,00 /108,25	41,952 /29,620	12,649 /4,069	0,6
Total ischemia time(min.)	80,00/ 83,19	25,616 /23,605	7,724/3,242	0,7
Recipient age	32,91 /40,81	15,940/11,637	4,806 /1,598	0,06
Recipient BW (kg.)	63,55/68,77	18,896/14,177	5,697/1,947	0,4
Recipient hospital stay	7,91/8,85	2,700/5,773	0,814/0,793	0,4

BW:Body weight None of the donors required blood transfusion. There was peritoneal tear in one case at the right side and ten cases at the left side. None of the patients had wound infection or incisional hernia. All transplanted kidneys had immediate function. All recipients had kidney functioning six months after transplantation.

We found that the result of right and left side donor nephrectomy with multiple arteries is same at HARP approach. Avoiding intraperitoneal complications is a quite promising reason to offer retroperitoneoscopic approach even for challenging cases such as right donor nephrectomy with multiple arteries.

To cite this abstract in AMA style:

Akin E, Barlas I, Dayangac M, Sinangil A, Celik V, Ecder T. Hand Assisted Retroperitoneoscopic Donor Nephrectomy in Challenging Cases; Right Sided Donor Nephrectomy With Multiple Renal Arteries [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/hand-assisted-retroperitoneoscopic-donor-nephrectomy-in-challenging-cases-right-sided-donor-nephrectomy-with-multiple-renal-arteries/. Accessed November 21, 2024.

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