Renal Vascular and Ureteral Anatomic Variations in 1859 Potential Living Renal Donors

Abstract

Renal vascular and ureteral anomalies detected by preoperative computed tomography angiography (CTA) are important for determining the side of the donor nephrectomy and the optimal surgical technique. In the present study, we aimed to examine the renal vascular and ureteral variations in living kidney donor candidates. A retrospective analysis was made of 1859 patients who were examined in our clinic as donor nephrectomy candidates between November 2008 and December 2019. Renal CTA images were acquired using a 64-channel multidetector computed tomography scanner, and renal vascular and ureteral variations were evaluated. The prevalence rates of multiple renal arteries on the right and left sides were 18.3% and 22.6%, respectively. The prevalence rates of early branching of the renal arteries, in turn, were 6.3% on the right side and 6.5% on the left side. The overall rate of renal artery variations on both the right and left sides was significantly higher in male individuals than in female individuals (P < .001). Multiple renal veins rates were 28.2% and 2.3% on the right and left sides, respectively, and the short renal veins rates on the right and left sides were 10.1% and 4.35%, respectively. Among the 941 cases undergoing donor nephrectomy, the procedure was completed by laparoscopy in 815 and by conversion from laparoscopic to open surgery in 36. The rate of vascular variations was higher in the conversion to open surgery group than in the laparoscopy group (P=.015). Careful preoperative assessments of donor renal vascular and ureteral anatomy and variations in CTA are essential for successful and safe renal transplant.