Living Donor Kidney Transplantation With Multiple Arteries: Recent Increase in Modern Era of Laparoscopic Donor Nephrectomy
OBJECTIVE To compare the outcome of living donor kidney transplantation using allografts with a single artery with that observed in recipients of allografts with multiple arteries. DESIGN Retrospective analysis. SETTING Tertiary center. PATIENTS Three hundred fifty patients who underwent living dono...
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| Veröffentlicht in: | Archives of surgery (Chicago. 1960) 2009-05, Vol.144 (5), p.472-475 |
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| creator | Saidi, Reza Kawai, Tatsuo Kennealey, Peter Tsouflas, Georgios Elias, Nahel Hertl, Martin Cosimi, A. B Ko, Dicken S. C |
| description | OBJECTIVE To compare the outcome of living donor kidney transplantation using allografts with a single artery with that observed in recipients of allografts with multiple arteries. DESIGN Retrospective analysis. SETTING Tertiary center. PATIENTS Three hundred fifty patients who underwent living donor kidney transplantation from January 2000 to March 2007. INTERVENTIONS Living donor kidney transplantation. MAIN OUTCOME MEASURES Surgical complications and allograft survival. RESULTS Three hundred nineteen allografts (91.1%) had a single artery (group 1) and 31 (8.9%) had multiple arteries (group 2), including 2 arteries in 21 grafts (67.8%), 3 arteries in 6 (19.3%), and 4 arteries in 4 grafts (12.9%). The operative time was shorter in group 1 compared with group 2 (mean [SD], 173 [35] vs 259 [48] minutes; P |
| doi_str_mv | 10.1001/archsurg.2009.49 |
| format | Article |
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B ; Ko, Dicken S. C</creator><creatorcontrib>Saidi, Reza ; Kawai, Tatsuo ; Kennealey, Peter ; Tsouflas, Georgios ; Elias, Nahel ; Hertl, Martin ; Cosimi, A. B ; Ko, Dicken S. C</creatorcontrib><description>OBJECTIVE To compare the outcome of living donor kidney transplantation using allografts with a single artery with that observed in recipients of allografts with multiple arteries. DESIGN Retrospective analysis. SETTING Tertiary center. PATIENTS Three hundred fifty patients who underwent living donor kidney transplantation from January 2000 to March 2007. INTERVENTIONS Living donor kidney transplantation. MAIN OUTCOME MEASURES Surgical complications and allograft survival. RESULTS Three hundred nineteen allografts (91.1%) had a single artery (group 1) and 31 (8.9%) had multiple arteries (group 2), including 2 arteries in 21 grafts (67.8%), 3 arteries in 6 (19.3%), and 4 arteries in 4 grafts (12.9%). The operative time was shorter in group 1 compared with group 2 (mean [SD], 173 [35] vs 259 [48] minutes; P < .001). The overall surgical complication rate in groups 1 and 2 was comparable (9.6% vs 9.7%; vascular, 2.8% vs 3.2%; urological, 1.6% vs 3.2%; symptomatic lymphocele, 2.8% vs 3.2%; and wound infections, 2.8% vs 3.2%). The actuarial 1- and 5-year allograft survival rates were comparable in both groups (98.4% and 91.5% in group 1 and 96.8% and 87.1% in group 2). A significant increased use of allografts with multiple arteries has been observed in recent years: 7.8% (n = 10) in grafts that were procured by open technique (n = 127), 4.1% (n = 5) during our initial experience with laparoscopic nephrectomy (n = 123), and 16% (n = 16) in the most recent 100 cases (P < .01). CONCLUSIONS Living donor kidney transplantation in the presence of multiple renal arteries is feasible and safe. Additionally, graft survival and graft function are not adversely affected by the presence of multiple renal arteries in grafts procured laparoscopically. Recently, there has been an increased use of kidneys with multiple arteries with excellent results.Arch Surg. 2009;144(5):472-475--></description><identifier>ISSN: 0004-0010</identifier><identifier>ISSN: 2168-6254</identifier><identifier>EISSN: 1538-3644</identifier><identifier>EISSN: 2168-6262</identifier><identifier>DOI: 10.1001/archsurg.2009.49</identifier><identifier>PMID: 19451491</identifier><identifier>CODEN: ARSUAX</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Angiography ; Biological and medical sciences ; Clinical outcomes ; Female ; General aspects ; Graft Survival ; Humans ; Kidney - blood supply ; Kidney - surgery ; Kidney Transplantation - methods ; Kidneys ; Laparoscopy - methods ; Living Donors ; Male ; Medical research ; Medical sciences ; Nephrectomy - methods ; Postoperative Complications ; Retrospective Studies ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Survival Rate ; Transplants & implants ; Treatment Outcome ; Veins & arteries</subject><ispartof>Archives of surgery (Chicago. 1960), 2009-05, Vol.144 (5), p.472-475</ispartof><rights>2009 INIST-CNRS</rights><rights>Copyright American Medical Association May 2009</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamasurgery/articlepdf/10.1001/archsurg.2009.49$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.2009.49$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3340,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21464303$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19451491$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saidi, Reza</creatorcontrib><creatorcontrib>Kawai, Tatsuo</creatorcontrib><creatorcontrib>Kennealey, Peter</creatorcontrib><creatorcontrib>Tsouflas, Georgios</creatorcontrib><creatorcontrib>Elias, Nahel</creatorcontrib><creatorcontrib>Hertl, Martin</creatorcontrib><creatorcontrib>Cosimi, A. B</creatorcontrib><creatorcontrib>Ko, Dicken S. C</creatorcontrib><title>Living Donor Kidney Transplantation With Multiple Arteries: Recent Increase in Modern Era of Laparoscopic Donor Nephrectomy</title><title>Archives of surgery (Chicago. 1960)</title><addtitle>Arch Surg</addtitle><description>OBJECTIVE To compare the outcome of living donor kidney transplantation using allografts with a single artery with that observed in recipients of allografts with multiple arteries. DESIGN Retrospective analysis. SETTING Tertiary center. PATIENTS Three hundred fifty patients who underwent living donor kidney transplantation from January 2000 to March 2007. INTERVENTIONS Living donor kidney transplantation. MAIN OUTCOME MEASURES Surgical complications and allograft survival. RESULTS Three hundred nineteen allografts (91.1%) had a single artery (group 1) and 31 (8.9%) had multiple arteries (group 2), including 2 arteries in 21 grafts (67.8%), 3 arteries in 6 (19.3%), and 4 arteries in 4 grafts (12.9%). The operative time was shorter in group 1 compared with group 2 (mean [SD], 173 [35] vs 259 [48] minutes; P < .001). The overall surgical complication rate in groups 1 and 2 was comparable (9.6% vs 9.7%; vascular, 2.8% vs 3.2%; urological, 1.6% vs 3.2%; symptomatic lymphocele, 2.8% vs 3.2%; and wound infections, 2.8% vs 3.2%). The actuarial 1- and 5-year allograft survival rates were comparable in both groups (98.4% and 91.5% in group 1 and 96.8% and 87.1% in group 2). A significant increased use of allografts with multiple arteries has been observed in recent years: 7.8% (n = 10) in grafts that were procured by open technique (n = 127), 4.1% (n = 5) during our initial experience with laparoscopic nephrectomy (n = 123), and 16% (n = 16) in the most recent 100 cases (P < .01). CONCLUSIONS Living donor kidney transplantation in the presence of multiple renal arteries is feasible and safe. Additionally, graft survival and graft function are not adversely affected by the presence of multiple renal arteries in grafts procured laparoscopically. Recently, there has been an increased use of kidneys with multiple arteries with excellent results.Arch Surg. 2009;144(5):472-475--></description><subject>Angiography</subject><subject>Biological and medical sciences</subject><subject>Clinical outcomes</subject><subject>Female</subject><subject>General aspects</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Kidney - blood supply</subject><subject>Kidney - surgery</subject><subject>Kidney Transplantation - methods</subject><subject>Kidneys</subject><subject>Laparoscopy - methods</subject><subject>Living Donors</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Nephrectomy - methods</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Survival Rate</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><subject>Veins & arteries</subject><issn>0004-0010</issn><issn>2168-6254</issn><issn>1538-3644</issn><issn>2168-6262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1v1DAQxS0EotvCHS7IQiq3LP5MYm5VKVCxBQkVcYxmnUnXVWIHO0Fa8c_j1YYicbEtzW9m3vMj5AVna84YfwvR7tIc79aCMbNW5hFZcS3rQpZKPSYrxpgqMsdOyGlK9_klaiOekhNulObK8BX5vXG_nL-j74MPkX52rcc9vY3g09iDn2BywdMfbtrRm7mf3NgjvYgTRofpHf2GFv1Er72NCAmp8_QmtBg9vYpAQ0c3MEIMyYbR2WXFFxx3Ee0Uhv0z8qSDPuHz5T4j3z9c3V5-KjZfP15fXmwKkEJPRdvWUGlVbqE2VmgDrS217FrNWqYqqyxuSyNrqUvJ0RhdqsoA31aZ0fks5Rl5c5w7xvBzxjQ1g0sW-2wQw5yashKaaS4z-Po_8D7M0WdtjchSdM0FyxA7QjY7SxG7ZoxugLhvOGsOqTR_U2kOqTTK5JZXy9x5O2D7r2GJIQPnCwDJQt_l_7cuPXCCq1JJdhD48sjBAA9VxZQRXP4BoLCfjQ</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Saidi, Reza</creator><creator>Kawai, Tatsuo</creator><creator>Kennealey, Peter</creator><creator>Tsouflas, Georgios</creator><creator>Elias, Nahel</creator><creator>Hertl, Martin</creator><creator>Cosimi, A. B</creator><creator>Ko, Dicken S. C</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20090501</creationdate><title>Living Donor Kidney Transplantation With Multiple Arteries: Recent Increase in Modern Era of Laparoscopic Donor Nephrectomy</title><author>Saidi, Reza ; Kawai, Tatsuo ; Kennealey, Peter ; Tsouflas, Georgios ; Elias, Nahel ; Hertl, Martin ; Cosimi, A. B ; Ko, Dicken S. 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Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Survival Rate</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><topic>Veins & arteries</topic><toplevel>online_resources</toplevel><creatorcontrib>Saidi, Reza</creatorcontrib><creatorcontrib>Kawai, Tatsuo</creatorcontrib><creatorcontrib>Kennealey, Peter</creatorcontrib><creatorcontrib>Tsouflas, Georgios</creatorcontrib><creatorcontrib>Elias, Nahel</creatorcontrib><creatorcontrib>Hertl, Martin</creatorcontrib><creatorcontrib>Cosimi, A. B</creatorcontrib><creatorcontrib>Ko, Dicken S. C</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of surgery (Chicago. 1960)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saidi, Reza</au><au>Kawai, Tatsuo</au><au>Kennealey, Peter</au><au>Tsouflas, Georgios</au><au>Elias, Nahel</au><au>Hertl, Martin</au><au>Cosimi, A. B</au><au>Ko, Dicken S. C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Living Donor Kidney Transplantation With Multiple Arteries: Recent Increase in Modern Era of Laparoscopic Donor Nephrectomy</atitle><jtitle>Archives of surgery (Chicago. 1960)</jtitle><addtitle>Arch Surg</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>144</volume><issue>5</issue><spage>472</spage><epage>475</epage><pages>472-475</pages><issn>0004-0010</issn><issn>2168-6254</issn><eissn>1538-3644</eissn><eissn>2168-6262</eissn><coden>ARSUAX</coden><abstract>OBJECTIVE To compare the outcome of living donor kidney transplantation using allografts with a single artery with that observed in recipients of allografts with multiple arteries. DESIGN Retrospective analysis. SETTING Tertiary center. PATIENTS Three hundred fifty patients who underwent living donor kidney transplantation from January 2000 to March 2007. INTERVENTIONS Living donor kidney transplantation. MAIN OUTCOME MEASURES Surgical complications and allograft survival. RESULTS Three hundred nineteen allografts (91.1%) had a single artery (group 1) and 31 (8.9%) had multiple arteries (group 2), including 2 arteries in 21 grafts (67.8%), 3 arteries in 6 (19.3%), and 4 arteries in 4 grafts (12.9%). The operative time was shorter in group 1 compared with group 2 (mean [SD], 173 [35] vs 259 [48] minutes; P < .001). The overall surgical complication rate in groups 1 and 2 was comparable (9.6% vs 9.7%; vascular, 2.8% vs 3.2%; urological, 1.6% vs 3.2%; symptomatic lymphocele, 2.8% vs 3.2%; and wound infections, 2.8% vs 3.2%). The actuarial 1- and 5-year allograft survival rates were comparable in both groups (98.4% and 91.5% in group 1 and 96.8% and 87.1% in group 2). A significant increased use of allografts with multiple arteries has been observed in recent years: 7.8% (n = 10) in grafts that were procured by open technique (n = 127), 4.1% (n = 5) during our initial experience with laparoscopic nephrectomy (n = 123), and 16% (n = 16) in the most recent 100 cases (P < .01). CONCLUSIONS Living donor kidney transplantation in the presence of multiple renal arteries is feasible and safe. Additionally, graft survival and graft function are not adversely affected by the presence of multiple renal arteries in grafts procured laparoscopically. Recently, there has been an increased use of kidneys with multiple arteries with excellent results.Arch Surg. 2009;144(5):472-475--></abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>19451491</pmid><doi>10.1001/archsurg.2009.49</doi><tpages>4</tpages></addata></record> |
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| subjects | Angiography Biological and medical sciences Clinical outcomes Female General aspects Graft Survival Humans Kidney - blood supply Kidney - surgery Kidney Transplantation - methods Kidneys Laparoscopy - methods Living Donors Male Medical research Medical sciences Nephrectomy - methods Postoperative Complications Retrospective Studies Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Survival Rate Transplants & implants Treatment Outcome Veins & arteries |
| title | Living Donor Kidney Transplantation With Multiple Arteries: Recent Increase in Modern Era of Laparoscopic Donor Nephrectomy |
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