Outcomes of Retroperitoneoscopic Live Donor Nephrectomy in Patients With Renal Artery Aneurysm.

Abstract

INTRODUCTION: Kidney transplantation with renal artery aneurysm (RAA) requires skilled technique for vascular reconstruction in bench surgery. Some cases are highly complicated and affect graft survival. We have been trying to establish a procedure of pure retroperitoneoscopic live donor nephrectomy (RPLDN). The outcomes of RPLDN in patients with RAA are not yet fully understood. In this study, we examine the outcome of recipient and donors with RAA using RPLDN at our institute. METHODS:Seven hundred sixty-four patients underwent live donor renal transplants with allografts procured by RPLDN at our institute between 2001 to 2013. Of these, 8 (1.0%) patients had renal artery aneurysms. Study variables included operative time, blood loss, warm ischemic time (WIT), total ischemic time (TIT), hospital stay, and early graft function. Surgical renovascular reconstructions were performed in all patients with RAA. RESULTS: Mean size of RAAs was 1.4 ± 0.7 cm (range: 0.9 - 2.8 cm). No significant differences were found between aneurysm and non-aneurysm groups regarding operative time, time to retrieval of the kidney, mean blood loss, hospital stay, or early graft function (Table 1). Post-operative bleeding and ureter stenosis that required reconstruction of the ureter were found in the aneurysm group. Univariate analysis showed RAA to have a risk factor of developing ureteral complications in recipients (p < 0.001) following RPLDN. CONCLUSIONS: RPLDN in patients with RAA could be an option for laparoscopic live donor nephrectomy because of excellent outcomes. On the other hand, post-operative ureteral complications should be carefully followed up following RPLDN.Table: No Caption available.