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Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels

INTRODUCTION: In kidney transplantation, total laparoscopic live donor nephrectomy (TLLDN) in the presence of multiple renal arteries (MRA) is technically challenging and has traditionally been associated with higher complication rates. We report our experience of using MRA grafts procured by TLLDN....

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Autores principales: Fitzpatrick, John, Chmelo, Jakub, Nambiar, Arjun, Fuge, Oliver, Page, Toby, Sen, Gourab, Soomro, Naeem, Rix, David, Rogers, Alistair, Talbot, David, Veeratterapillay, Rajan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546076/
https://www.ncbi.nlm.nih.gov/pubmed/33100753
http://dx.doi.org/10.4103/UA.UA_96_19
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author Fitzpatrick, John
Chmelo, Jakub
Nambiar, Arjun
Fuge, Oliver
Page, Toby
Sen, Gourab
Soomro, Naeem
Rix, David
Rogers, Alistair
Talbot, David
Veeratterapillay, Rajan
author_facet Fitzpatrick, John
Chmelo, Jakub
Nambiar, Arjun
Fuge, Oliver
Page, Toby
Sen, Gourab
Soomro, Naeem
Rix, David
Rogers, Alistair
Talbot, David
Veeratterapillay, Rajan
author_sort Fitzpatrick, John
collection PubMed
description INTRODUCTION: In kidney transplantation, total laparoscopic live donor nephrectomy (TLLDN) in the presence of multiple renal arteries (MRA) is technically challenging and has traditionally been associated with higher complication rates. We report our experience of using MRA grafts procured by TLLDN. MATERIALS AND METHODS: Patients undergoing TLLDN at our center (2004–2014) was identified from a prospectively maintained database and divided into single renal arteries (SRA) or MRA groups. Recipient perioperative parameters, postoperative complications, and long-term graft survival were analyzed. RESULTS: Of 465 patients, 106 had MRA and 359 had an SRA. There were six vascular complications in the SRA group and two in the MRA group (1.7% vs. 1.8%). There were eight ureteric complications requiring intervention in the SRA group compared to three in the MRA group (4% vs. 3%; P = 0.45). Acute rejection was observed in 12% of the SRA group compared to 9% in the MRA group (P = 0.23). One-, 5- and 10-year graft survivals were 98.2%, 91.3%, and 89.8% in the MRA group versus 98.0%, 90.4%, and 77.5% in the SRA group (log-rank P = 0.13). CONCLUSION: The use of MRA grafts procured by TLLDN has comparable complication rates to SRA grafts and should not preclude selection for renal transplantation.
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spelling pubmed-75460762020-10-22 Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels Fitzpatrick, John Chmelo, Jakub Nambiar, Arjun Fuge, Oliver Page, Toby Sen, Gourab Soomro, Naeem Rix, David Rogers, Alistair Talbot, David Veeratterapillay, Rajan Urol Ann Original Article INTRODUCTION: In kidney transplantation, total laparoscopic live donor nephrectomy (TLLDN) in the presence of multiple renal arteries (MRA) is technically challenging and has traditionally been associated with higher complication rates. We report our experience of using MRA grafts procured by TLLDN. MATERIALS AND METHODS: Patients undergoing TLLDN at our center (2004–2014) was identified from a prospectively maintained database and divided into single renal arteries (SRA) or MRA groups. Recipient perioperative parameters, postoperative complications, and long-term graft survival were analyzed. RESULTS: Of 465 patients, 106 had MRA and 359 had an SRA. There were six vascular complications in the SRA group and two in the MRA group (1.7% vs. 1.8%). There were eight ureteric complications requiring intervention in the SRA group compared to three in the MRA group (4% vs. 3%; P = 0.45). Acute rejection was observed in 12% of the SRA group compared to 9% in the MRA group (P = 0.23). One-, 5- and 10-year graft survivals were 98.2%, 91.3%, and 89.8% in the MRA group versus 98.0%, 90.4%, and 77.5% in the SRA group (log-rank P = 0.13). CONCLUSION: The use of MRA grafts procured by TLLDN has comparable complication rates to SRA grafts and should not preclude selection for renal transplantation. Wolters Kluwer - Medknow 2020 2020-07-17 /pmc/articles/PMC7546076/ /pubmed/33100753 http://dx.doi.org/10.4103/UA.UA_96_19 Text en Copyright: © 2020 Urology Annals http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Fitzpatrick, John
Chmelo, Jakub
Nambiar, Arjun
Fuge, Oliver
Page, Toby
Sen, Gourab
Soomro, Naeem
Rix, David
Rogers, Alistair
Talbot, David
Veeratterapillay, Rajan
Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels
title Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels
title_full Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels
title_fullStr Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels
title_full_unstemmed Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels
title_short Recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels
title_sort recipient outcomes in total laparoscopic live donor nephrectomy with multiple renal vessels
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546076/
https://www.ncbi.nlm.nih.gov/pubmed/33100753
http://dx.doi.org/10.4103/UA.UA_96_19
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