Introduction:

Laparoscopic donor nephrectomy (LDN) is the preferred procedure to procure kidneys from most living donors (LDs). However, transplant surgeons might shy away from LDN when dealing with a LD with multiple renal arteries (MRA). The aim of this study is to compare donors of laparoscopically procured kidneys with MRA and single renal artery (SRA) outcomes, and their recipients' outcomes.

Methods:

Medical records of all donors who underwent LDN, between April 2009 to October 2014, and their recipients were reviewed. Operative time, warm ischemia time (WIT), cold ischemia time (CIT), post operative complications, and length of stay (LOS) were compared between MRA and SRA kidney donors. Immediate graft function and short-term outcomes of recipients of kidneys with MRA and SRA were compared too.

Results:

250 LDNs were done; 40 MRA kidneys and 210 SRA kidneys. The mean operative time was statistically longer in MRA kidneys; 168.6 min (157 – 180 min) compared with SRA kidneys 135.0 min (125 – 145 min), P < 0.001. The mean WIT and CIT were the same. No single case of LDN converted to open procedure in MRA kidney donors, and no reported post operative complications. LOS was the same, 4.7 days for MRA kidney donors and 4.0 days for SRA kidney donors. Recipients of MRA kidneys had the same outcome as recipients of SRA kidneys. No cases of delayed graft function, no vascular complications seen, and day-30 graft functions were comparable between the two groups.

Conclusion:

LDN of MRA kidneys is a safe procedure, and graft outcomes among recipients of laparoscopically procured kidneys with MRA are excellent. LDN should be the standard of care in kidney procurement from LDs regardless the number of renal arteries.

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