Living donor kidney transplantation using laparoscopically procured multiple renal artery kidneys and right kidneys

Marcio F. Chedid, Carl Muthu, Scott Nyberg, Timothy G. Lesnick, Walter K Kremers, Mikel Prieto, Julie K. Heimbach, George K. Chow, Mark D Stegall, Patrick G. Dean

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: The use of kidneys with multiple renal arteries (MRA) and right kidneys procured laparoscopically for living donor kidney transplantation (LDKT) remains controversial. We aimed to evaluate the short- and long-term outcomes of recipients of LDKT using laparoscopically procured MRA and right kidneys. Study Design: We reviewed the medical records of all LDKT recipients with laparoscopically procured kidneys from 2000 to 2009. Pediatric recipients and recipients of positive crossmatch and/or ABO-incompatible transplants were excluded. We compared the outcomes of recipients of MRA kidneys with those receiving single renal artery (SRA) kidneys and the outcomes of recipients of right kidneys with those of left kidneys. Renal function was measured by iothalamate clearance and estimated by the abbreviated Modification of Diet in Renal Disease equation. Results: Multiple renal artery kidneys (192 2-artery and 18 3-artery kidneys) were used in 210 (18.5%) of 1,134 transplantations. The most common reconstructive technique used for MRA kidneys was a side-to-side anastomosis (64.3%). There were no significant differences in vascular complications (1.1% vs 2.4%, p = 0.17), urologic complications (3.1% vs 2.9%, p = 0.47), graft survival at 1 year (94.6% vs 96.1%, p = 0.37), and 1-year iothalamate clearance (64 mL/min/1.73 m2 vs 66 mL/min/1.73 m 2, p = 0.52) between recipients of SRA and MRA kidneys. Five-year graft survival was similar for recipients of SRA and MRA kidneys (83.6% vs 82.6%, p = 0.82) and for recipients of left vs right kidneys (83.7% vs 82.6%, p = 0.70). Conclusions: Excellent long-term outcomes can be obtained after LDKT using laparoscopically procured MRA and right-sided donor kidneys. Unavailability of an SRA left kidney should not preclude LDKT.

Original languageEnglish (US)
Pages (from-to)144-152
Number of pages9
JournalJournal of the American College of Surgeons
Volume217
Issue number1
DOIs
StatePublished - Jul 2013

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Living Donors
Renal Artery
Kidney Transplantation
Kidney
Iothalamic Acid
Graft Survival
Arteries
Diet Therapy

ASJC Scopus subject areas

  • Surgery

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Living donor kidney transplantation using laparoscopically procured multiple renal artery kidneys and right kidneys. / Chedid, Marcio F.; Muthu, Carl; Nyberg, Scott; Lesnick, Timothy G.; Kremers, Walter K; Prieto, Mikel; Heimbach, Julie K.; Chow, George K.; Stegall, Mark D; Dean, Patrick G.

In: Journal of the American College of Surgeons, Vol. 217, No. 1, 07.2013, p. 144-152.

Research output: Contribution to journalArticle

Chedid, Marcio F. ; Muthu, Carl ; Nyberg, Scott ; Lesnick, Timothy G. ; Kremers, Walter K ; Prieto, Mikel ; Heimbach, Julie K. ; Chow, George K. ; Stegall, Mark D ; Dean, Patrick G. / Living donor kidney transplantation using laparoscopically procured multiple renal artery kidneys and right kidneys. In: Journal of the American College of Surgeons. 2013 ; Vol. 217, No. 1. pp. 144-152.
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abstract = "Background: The use of kidneys with multiple renal arteries (MRA) and right kidneys procured laparoscopically for living donor kidney transplantation (LDKT) remains controversial. We aimed to evaluate the short- and long-term outcomes of recipients of LDKT using laparoscopically procured MRA and right kidneys. Study Design: We reviewed the medical records of all LDKT recipients with laparoscopically procured kidneys from 2000 to 2009. Pediatric recipients and recipients of positive crossmatch and/or ABO-incompatible transplants were excluded. We compared the outcomes of recipients of MRA kidneys with those receiving single renal artery (SRA) kidneys and the outcomes of recipients of right kidneys with those of left kidneys. Renal function was measured by iothalamate clearance and estimated by the abbreviated Modification of Diet in Renal Disease equation. Results: Multiple renal artery kidneys (192 2-artery and 18 3-artery kidneys) were used in 210 (18.5{\%}) of 1,134 transplantations. The most common reconstructive technique used for MRA kidneys was a side-to-side anastomosis (64.3{\%}). There were no significant differences in vascular complications (1.1{\%} vs 2.4{\%}, p = 0.17), urologic complications (3.1{\%} vs 2.9{\%}, p = 0.47), graft survival at 1 year (94.6{\%} vs 96.1{\%}, p = 0.37), and 1-year iothalamate clearance (64 mL/min/1.73 m2 vs 66 mL/min/1.73 m 2, p = 0.52) between recipients of SRA and MRA kidneys. Five-year graft survival was similar for recipients of SRA and MRA kidneys (83.6{\%} vs 82.6{\%}, p = 0.82) and for recipients of left vs right kidneys (83.7{\%} vs 82.6{\%}, p = 0.70). Conclusions: Excellent long-term outcomes can be obtained after LDKT using laparoscopically procured MRA and right-sided donor kidneys. Unavailability of an SRA left kidney should not preclude LDKT.",
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AU - Chedid, Marcio F.

AU - Muthu, Carl

AU - Nyberg, Scott

AU - Lesnick, Timothy G.

AU - Kremers, Walter K

AU - Prieto, Mikel

AU - Heimbach, Julie K.

AU - Chow, George K.

AU - Stegall, Mark D

AU - Dean, Patrick G.

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N2 - Background: The use of kidneys with multiple renal arteries (MRA) and right kidneys procured laparoscopically for living donor kidney transplantation (LDKT) remains controversial. We aimed to evaluate the short- and long-term outcomes of recipients of LDKT using laparoscopically procured MRA and right kidneys. Study Design: We reviewed the medical records of all LDKT recipients with laparoscopically procured kidneys from 2000 to 2009. Pediatric recipients and recipients of positive crossmatch and/or ABO-incompatible transplants were excluded. We compared the outcomes of recipients of MRA kidneys with those receiving single renal artery (SRA) kidneys and the outcomes of recipients of right kidneys with those of left kidneys. Renal function was measured by iothalamate clearance and estimated by the abbreviated Modification of Diet in Renal Disease equation. Results: Multiple renal artery kidneys (192 2-artery and 18 3-artery kidneys) were used in 210 (18.5%) of 1,134 transplantations. The most common reconstructive technique used for MRA kidneys was a side-to-side anastomosis (64.3%). There were no significant differences in vascular complications (1.1% vs 2.4%, p = 0.17), urologic complications (3.1% vs 2.9%, p = 0.47), graft survival at 1 year (94.6% vs 96.1%, p = 0.37), and 1-year iothalamate clearance (64 mL/min/1.73 m2 vs 66 mL/min/1.73 m 2, p = 0.52) between recipients of SRA and MRA kidneys. Five-year graft survival was similar for recipients of SRA and MRA kidneys (83.6% vs 82.6%, p = 0.82) and for recipients of left vs right kidneys (83.7% vs 82.6%, p = 0.70). Conclusions: Excellent long-term outcomes can be obtained after LDKT using laparoscopically procured MRA and right-sided donor kidneys. Unavailability of an SRA left kidney should not preclude LDKT.

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