Outcome of renal transplantation with multiple versus single renal arteries after laparoscopic live donor nephrectomy: a comparative study

Abstract

Objectives: To compare donor morbidity and recipient outcomes in patients with a single artery versus multiple arteries undergoing laparoscopic donor nephrectomy.

Methods: A total of 303 consecutive laparoscopic donor nephrectomies were performed. Data from the group with multiple arteries (n = 27) (group I) were compared with those from the groups with single renal artery (n = 245) (group IIA) and early branching renal artery resulting in two artery recipient anastomoses (n = 31) (group IIB), in terms of donor and recipient outcomes.

Results: Laparoscopic donor nephrectomy was technically successful in all 303 patients without need for open conversion. The graft retrieval time was higher in group I and group IIB compared with group IIA (3.9 +/- 1.4 and 3.9 +/- 0.8 versus 3.5 +/- 1.0 minutes). Similarly, warm ischemia time was significantly higher in groups I and IIB versus group IIA (7.2 +/- 1.9 and 6.7 +/- 1.9 versus 5.6 +/- 1.8 minutes). Creatinine level at day 1 was higher in group I compared with group IIA (2.4 +/- 1.4 versus 1.9 +/- 0.7 mg/dL). However, there was no significant difference in creatinine levels at 1 month and 1 year among the three groups. Overall graft survival in groups I, IIA, and IIB was 92%, 94.4%, and 94%, respectively.

Conclusions: Laparoscopic donor nephrectomy in the presence of multiple renal arteries is feasible and safe. Additionally, long-term graft survival and graft function at 1 month and 1 year are not adversely impacted by the presence of multiple renal arteries in grafts procured laparoscopically.