Laparo-Endoscopic Single-Site Left Donor Nephrectomy In Patients With Uncommon Renal Vascular Anatomy: Does the Technique Make a Difference?

Autor: El Hennawy HM; Surgery Department, Section of Transplantation, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia. Electronic address: hennawyhany@hotmail.com., Safar O; Urology Department, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia., Atta EA; Surgery Department, Section of Transplantation, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia., Elatreisy A; Urology Department, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia; Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Shalkamy O; Urology Department, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia; Urology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., El Madawie MZ; Urology Department, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia., Alqahtani SA; Surgery Department, Section of Transplantation, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia., Mahedy A; Nephrology Department, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia., Elgamal GA; Anesthesia Department, Armed Forces Hospitals Southern Region, Khamis Mushayte, 101, Saudi Arabia; Anesthesia Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt., Zaitoun MF; Pharmacy Department, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia., Al Faifi AS; Surgery Department, Section of Transplantation, Armed Forces Hospitals Southern Region, Khamis Mushayte, Saudi Arabia.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2024 Jan-Feb; Vol. 56 (1), pp. 16-22. Date of Electronic Publication: 2024 Jan 18.
DOI: 10.1016/j.transproceed.2023.11.007
Abstrakt: Background: To compare donor and recipient outcomes in patients with renal artery and ante-aortic renal vein vs unusual renal vascular anatomy undergoing laparoendoscopic single-site donor nephrectomy (LESSDN).
Methods: A retrospective chart review of the comparative study of donor and recipient outcomes of LESSDN in donors with venous abnormality (n = 28, group A), arterial abnormality (n = 74, group B), and standard donors (n = 248, group C).
Results: From September 2016 to August 2022, 350 left LESSDN were performed. The most common anomalies in group A were the retro-aortic and 2 renal veins in 12 patients each. In group B, 72 and 2 patients had 2 and 3 renal arteries, respectively. Operative and warm ischemia times were significantly longer in donors with vascular anomalies. Moreover, patient creatinine on discharge was significantly higher in arterial anomalies; it was 1.61 ± 0.22 compared with 1.26 ± 0.43 and 1.25 ± 0.32 mg/dL for patients with no anomalies and venous anomalies, respectively (P < .001). However, serum creatinine levels recovered after 1 month and were comparable between the study groups. Recipients, operative time, and vascular anastomosis time were significantly longer in recipients with vascular anomaly. Slow graft function was higher in group B (6.9%) than in the other groups. One-year graft survival rates were 96.4%, 94.6%, and 97.1% (P = .496).
Conclusion: With increased experience, LESSDN in multiple renal arteries and uncommon venous anatomy cases is feasible and safe. Moreover, it does not influence donor or recipient outcomes.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: