Outcome of Kidney Transplantation Using Right Versus Three Left Renal Arteries After Retroperitoneoscopic Donor Nephrectomy: A Single-Center Experience of 764 Cases

K. Omoto, M. Okumi, T. Shimizu, D. Toki, H. Ishida, K. Tanabe.

Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.

Meeting: 2015 American Transplant Congress

Abstract number: B195

Keywords: Donors, Graft survival, marginal, Nephrectomy, Warm ischemia

Session Information

Session Name: Poster Session B: Living Donor Issues 1

Session Type: Poster Session

Date: Sunday, May 3, 2015

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

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

Location: Exhibit Hall E

OBJECTIVE:

In laparoscopic donor nephrectomy (LDN), technical problems are less common in the right side than in the left side. In addition, several study series have shown initially high rates of complications and graft loss in left LDN with multiple renal arteries. The objective of this study was to assess the effect of right LDN and left renal artery multiplicity, especially 3 renal arteries, on donor and recipient outcomes after retroperitoneoscopic LDN (RPLDN).

METHODS:

During a 12-year period, 764 patients underwent living-donor renal transplantations with allografts procured via RPLDN at our institute. Of the patients, 32 (4.2%) and 30 (3.9%) had right (R group) and 3 left renal arteries (L3 group), respectively. Surgical renovascular reconstructions were performed in patients with multiple renal arteries.

RESULTS:

The total ischemic time in the L3 group was significantly longer than that in the R group. No significant differences were observed between the R and L3 groups regarding operative time, blood loss, warm ischemic time, hospital stay, and early graft function (Tables 1 and 2).

Table 1. Outcome of donor surgery using RPLDN.
	R group (n=32)	L3 group (n=30)	P value
Operative time (min)	304 ± 69	330 ± 89	0.202
Blood loss (g)	51 ± 52	68 ± 81	0.326
WIT (min)	6.1 ± 1.9	5.7 ± 2.5	0.479
TIT (min)	101 ± 28	137 ± 32	<0.001
Hospital stay (days)	4.0 ± 1.1	4.5 ± 2.1	0.241

WIT: warm ischemic time; TIT: total ischemic time.

Table 2. Early posttransplant renal function using RPLDN.
	R group (n=32)	L3 group (n=30)	P value
SGF (%)	1 (3.1)	4 (13)	0.156
DGF (%)	0	0	–
sCr at POD 7 (mg/dl)	1.9 ± 1.7	1.5 ± 0.7	0.374
sCr at POD 14 (mg/dl)	1.8 ± 1.4	1.5 ± 0.7	0.846

SGF: slow graft function; DGF: delayed graft function; sCr: serum creatinin; POD: post operative day Moreover, no significant difference was observed between 2 groups regarding the incidence of complications (R vs. L3 group: 12.5% vs. 13.3%). Graft survival rate did not significantly differ between the 2 groups (Figure 1).

CONCLUSIONS:

The right and left kidneys with 3 renal arteries had similar excellent outcomes after RPLDN.

To cite this abstract in AMA style:

Omoto K, Okumi M, Shimizu T, Toki D, Ishida H, Tanabe K. Outcome of Kidney Transplantation Using Right Versus Three Left Renal Arteries After Retroperitoneoscopic Donor Nephrectomy: A Single-Center Experience of 764 Cases [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/outcome-of-kidney-transplantation-using-right-versus-three-left-renal-arteries-after-retroperitoneoscopic-donor-nephrectomy-a-single-center-experience-of-764-cases/. Accessed November 21, 2024.

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