Laparoscopic living donor nephrectomy for kidneys with multiple arteries

Laparoscopic donor nephrectomy (LDN) involving kidneys with multiple arterial vessels is limited to a small number of reports, with all but two series reporting fewer than 25 patients. Moreover, outside of the pioneering centers at the University of Maryland and Johns Hopkins, no series of at least 25 patients has been published confirming these experience. The present study presents the largest series of LDN of donor kidneys with multiple arterial vessels outside of these two pioneering programs.

All LDN performed at the University of Cincinnati from 2000 to 2004 were reviewed. Results between LDN kidneys with a single vessel and those with multiple vessels were compared. Statistical analysis included chi-square and Student t test.

Of 240 LDN, 37 were performed for kidneys with multiple vessels (15%): nine right kidneys (25%) and 28 left kidneys (75%). Cold ischemia time was longer for the multiple vessel organs (46 +/- 24 minutes) than for single vessel organs (35 +/- 13 minutes; P = .001), and warm ischemia time was longer for the multiple vessel kidneys (4:20 +/- 2:05 minutes) than single vessel kidneys (3:13 +/- 0:47 minutes; P = .001). Recipient renal function (serum creatinine) was similar for multiple and single artery donors at postoperative day 7 (1.76 +/- 1.38 and 1.7 +/- 1.47) and at postoperative day 365 (1.06 +/- 0.3 and 1.34 +/- 0.44).

This experience confirms results from other series in documenting the safety and reproducibility of LDN for kidneys with multiple arterial vessels.