Living donor kidney transplantation with multiple renal arteries in the laparoscopic era

M. D. Tyson, Erik P Castle, E. Y. Ko, P. E. Andrews, R. L. Heilman, K. L. Mekeel, A. A. Moss, D. C. Mulligan, Kunam Sudhakar Reddy

Research output: Contribution to journalArticle

Abstract

Objectives: To compare the postoperative complications and survival metrics after multiple renal arteries (MRA) and single renal artery (SRA) laparoscopically procured living donor kidney transplantation (LLDKT). MRA are the most frequently encountered anatomic variation during kidney transplantation. The longterm outcomes of LLDKT with MRA are not well characterized. Methods: A retrospective review of our institution's LLDKT database was performed. All surgeries were performed at a single tertiary care academic center between June 1999 and September 2008. Patients were divided into 2 cohorts (MRA vs. SRA), and analysis was limited to patients with at least 1-year follow-up. Results: Of 584 LLDKTs, 510 had at least 1-year follow-up (median: 36 months). A total of 393 grafts had an SRA, whereas 117 (23%) had MRA. When complications were stratified by the Clavien classification system, no differences were noted between groups (P = .5). Furthermore, rates of vascular (P = .2) and urological (P = .9) complications were similar between groups. There was, however, a higher incidence of slow graft function in the MRA group (P = .01), despite similar rates of delayed graft function (P = .9) and acute rejection (P = .4). Furthermore, allograft survival was similar between both groups with 76% of MRA and 81% of SRA grafts functioning at 5 years (P = .49). Patient overall survival was likewise similar between groups with 88% of MRA and 86% of SRA recipients surviving at 5 years (P = .76). Conclusions: Despite a higher incidence slow graft function, MRA in LLDKT does not adversely affect longterm allograft and patient overall survival.

Original languageEnglish (US)
Pages (from-to)401
Number of pages1
JournalInternational Braz J Urol
Volume37
Issue number3
DOIs
StatePublished - May 2011

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Living Donors
Renal Artery
Kidney Transplantation
Transplants
Allografts
Survival
Delayed Graft Function
Anatomic Variation
Incidence
Tertiary Care Centers
Blood Vessels

ASJC Scopus subject areas

  • Urology

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Living donor kidney transplantation with multiple renal arteries in the laparoscopic era. / Tyson, M. D.; Castle, Erik P; Ko, E. Y.; Andrews, P. E.; Heilman, R. L.; Mekeel, K. L.; Moss, A. A.; Mulligan, D. C.; Reddy, Kunam Sudhakar.

In: International Braz J Urol, Vol. 37, No. 3, 05.2011, p. 401.

Research output: Contribution to journalArticle

Tyson, M. D. ; Castle, Erik P ; Ko, E. Y. ; Andrews, P. E. ; Heilman, R. L. ; Mekeel, K. L. ; Moss, A. A. ; Mulligan, D. C. ; Reddy, Kunam Sudhakar. / Living donor kidney transplantation with multiple renal arteries in the laparoscopic era. In: International Braz J Urol. 2011 ; Vol. 37, No. 3. pp. 401.
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abstract = "Objectives: To compare the postoperative complications and survival metrics after multiple renal arteries (MRA) and single renal artery (SRA) laparoscopically procured living donor kidney transplantation (LLDKT). MRA are the most frequently encountered anatomic variation during kidney transplantation. The longterm outcomes of LLDKT with MRA are not well characterized. Methods: A retrospective review of our institution's LLDKT database was performed. All surgeries were performed at a single tertiary care academic center between June 1999 and September 2008. Patients were divided into 2 cohorts (MRA vs. SRA), and analysis was limited to patients with at least 1-year follow-up. Results: Of 584 LLDKTs, 510 had at least 1-year follow-up (median: 36 months). A total of 393 grafts had an SRA, whereas 117 (23{\%}) had MRA. When complications were stratified by the Clavien classification system, no differences were noted between groups (P = .5). Furthermore, rates of vascular (P = .2) and urological (P = .9) complications were similar between groups. There was, however, a higher incidence of slow graft function in the MRA group (P = .01), despite similar rates of delayed graft function (P = .9) and acute rejection (P = .4). Furthermore, allograft survival was similar between both groups with 76{\%} of MRA and 81{\%} of SRA grafts functioning at 5 years (P = .49). Patient overall survival was likewise similar between groups with 88{\%} of MRA and 86{\%} of SRA recipients surviving at 5 years (P = .76). Conclusions: Despite a higher incidence slow graft function, MRA in LLDKT does not adversely affect longterm allograft and patient overall survival.",
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T1 - Living donor kidney transplantation with multiple renal arteries in the laparoscopic era

AU - Tyson, M. D.

AU - Castle, Erik P

AU - Ko, E. Y.

AU - Andrews, P. E.

AU - Heilman, R. L.

AU - Mekeel, K. L.

AU - Moss, A. A.

AU - Mulligan, D. C.

AU - Reddy, Kunam Sudhakar

PY - 2011/5

Y1 - 2011/5

N2 - Objectives: To compare the postoperative complications and survival metrics after multiple renal arteries (MRA) and single renal artery (SRA) laparoscopically procured living donor kidney transplantation (LLDKT). MRA are the most frequently encountered anatomic variation during kidney transplantation. The longterm outcomes of LLDKT with MRA are not well characterized. Methods: A retrospective review of our institution's LLDKT database was performed. All surgeries were performed at a single tertiary care academic center between June 1999 and September 2008. Patients were divided into 2 cohorts (MRA vs. SRA), and analysis was limited to patients with at least 1-year follow-up. Results: Of 584 LLDKTs, 510 had at least 1-year follow-up (median: 36 months). A total of 393 grafts had an SRA, whereas 117 (23%) had MRA. When complications were stratified by the Clavien classification system, no differences were noted between groups (P = .5). Furthermore, rates of vascular (P = .2) and urological (P = .9) complications were similar between groups. There was, however, a higher incidence of slow graft function in the MRA group (P = .01), despite similar rates of delayed graft function (P = .9) and acute rejection (P = .4). Furthermore, allograft survival was similar between both groups with 76% of MRA and 81% of SRA grafts functioning at 5 years (P = .49). Patient overall survival was likewise similar between groups with 88% of MRA and 86% of SRA recipients surviving at 5 years (P = .76). Conclusions: Despite a higher incidence slow graft function, MRA in LLDKT does not adversely affect longterm allograft and patient overall survival.

AB - Objectives: To compare the postoperative complications and survival metrics after multiple renal arteries (MRA) and single renal artery (SRA) laparoscopically procured living donor kidney transplantation (LLDKT). MRA are the most frequently encountered anatomic variation during kidney transplantation. The longterm outcomes of LLDKT with MRA are not well characterized. Methods: A retrospective review of our institution's LLDKT database was performed. All surgeries were performed at a single tertiary care academic center between June 1999 and September 2008. Patients were divided into 2 cohorts (MRA vs. SRA), and analysis was limited to patients with at least 1-year follow-up. Results: Of 584 LLDKTs, 510 had at least 1-year follow-up (median: 36 months). A total of 393 grafts had an SRA, whereas 117 (23%) had MRA. When complications were stratified by the Clavien classification system, no differences were noted between groups (P = .5). Furthermore, rates of vascular (P = .2) and urological (P = .9) complications were similar between groups. There was, however, a higher incidence of slow graft function in the MRA group (P = .01), despite similar rates of delayed graft function (P = .9) and acute rejection (P = .4). Furthermore, allograft survival was similar between both groups with 76% of MRA and 81% of SRA grafts functioning at 5 years (P = .49). Patient overall survival was likewise similar between groups with 88% of MRA and 86% of SRA recipients surviving at 5 years (P = .76). Conclusions: Despite a higher incidence slow graft function, MRA in LLDKT does not adversely affect longterm allograft and patient overall survival.

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