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Choi, Jung, Jung, Cho, Hong, Kim, Park, and Hwang: Feasibility and Safety of Performing Hand-assisted Laparoscopic Donor Nephrectomy for Patients with Multiple Renal Arteries
Original Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(5): 443-448.

Published online: 31 May 2008

DOI: https://doi.org/10.4111/kju.2008.49.5.443

Feasibility and Safety of Performing Hand-assisted Laparoscopic Donor Nephrectomy for Patients with Multiple Renal Arteries

Hang Won Choi, Jin-Woo Jung, Jo Un Jung, Hyuk Jin Cho, Sung-Hoo Hong, Joon Chul Kim, Yong Hyun Park, Tae-Kon Hwang

Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

tkhwang@catholic.ac.kr

Received 9 January 2008       Accepted 10 April 2008

Copyright © 2008 The Korean Urological Association

Abstract

Purpose

We wanted to present the feasibility and safety of hand-assisted laparoscopic donor nephrectomy (HALDN) for treating patients with multiple renal arteries.

Materials and Methods

Between February 2000 and July 2006, 252 patients underwent HALDN. The results for the patients with a single renal artery (n=187) (Group I) and those patients with multiple renal arteries (n=65) (Group II) were compared in terms of the donor and recipient outcomes. A retrospective chart review was performed and statistical analysis included Student's t-test, the chi square test and Kaplan-Meier survival probability analysis.

Results

HALDN was technically successful in 251 patients (1 patient had to be converted to open donor nephrectomy). The operative times were increased in group II, but the differences between the groups were not statistically significant. The warm ischemic times were significantly longer in group II. The intraoperative blood loss, postoperative hospital stay and complication rate in the donor group were not associated with the number of renal arteries. The recipients' renal function and overall graft survival were similar between groups I and II.

Conclusions

In our single-center study, the presence of renal artery multiplicity when performing HALDN does not have a significant impact on the outcomes of the renal donors or recipients.

Keywords: Kidney transplantation, Laparoscopy, Living donors, Hand, Renal artery

Figures and Tables

Fig. 1
Overall survival probabilities of the graft kidneys. Thin line: Group I, Thick line: Group II, *p=0.672 using the log-rank test, 0.891 using the Breslow test.
kju-49-443-g001
Table 1
Characteristics of the donors and recipients
kju-49-443-i001

*BMI: body mass index, HALDN: hand-assisted laparoscopic donor nephrectomy

Table 2
Comparison of the intraoperative and postoperative parameters between Groups I and II
kju-49-443-i002
Table 3
Comparison of the intraoperative and postoperative parameters between the recipients of Groups I and II
kju-49-443-i003

TIT: total ischemic time, Cr: creatinine, POD: postoperative day

Table 4
Comparison of the intraoperative and postoperative parameters between Groups IIa and IIb
kju-49-443-i004

Group IIa: group with 2 renal arteries, Group IIb: group with more than 2 renal arteries

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