Kacar Serdar, Gurkan Alp, Akman Fatih, Varýlsuha Can, Karaca Cezmi, Karaoglan Muharrem
SSK Tepecik Hospital, Organ Transplantation Unit, Izmir, Turkey.
Ann Transplant. 2005;10(2):34-7.
Laparoscopic donor nephrectomy has gained popularity throughout the world recently. The more centers became experienced the more this technique began to be used, even in extreme cases. Kidneys with multiple renal arteries are one of the difficult cases for laparoscopic donor nephrectomy.
Thirty living laparoscopic donor nephrectomies have been performed between January 2001 and December 2002. Twenty-three of them had single and seven kidneys had multiple renal arteries. Single (SA) and multiple (MA) artery groups were statistically similar in terms of donor age, rate of received right kidneys and serum creatinine clearance of the donors.
The mean duration of the donor surgery was 225 min and 240 min in SA and MA groups. In the SA and MA groups, the mean warm and cold ischemia times were statistically similar. Laparoscopic nephrectomy was converted to open procedure in five and one donors, in the SA and MA artery groups, respectively. Intraoperative bleeding (single artery: 4, multiple arteries: 1) was the most common cause for conversion. Postoperative urinary complications were seen in four and one patients, in the SA and MA groups, respectively. Lengths of hospital stay of the donors were similar in both groups. Serum creatinine levels of the patients on seventh, 30th, 90th days, and 1 year were found to be statistically similar in both groups.
Laparoscopic donor nephrectomy was found to be a safe procedure in the donors with multiple renal arteries by the experienced surgical teams, as much as in donors with single arteries.
近年来，腹腔镜供肾切除术在全球范围内越来越受欢迎。随着越来越多的中心积累了经验，这项技术的应用也越来越广泛，甚至在极端情况下也被采用。有多支肾动脉的肾脏是腹腔镜供肾切除术的难点病例之一。
2001年1月至2002年12月期间共进行了30例活体腹腔镜供肾切除术。其中23例为单支肾动脉，7例有多支肾动脉。单支（SA）和多支（MA）动脉组在供体年龄、接受右肾的比例以及供体血清肌酐清除率方面具有统计学相似性。
SA组和MA组供体手术的平均时长分别为225分钟和240分钟。SA组和MA组的平均热缺血时间和冷缺血时间在统计学上相似。SA组和MA组分别有5例和1例供体的腹腔镜肾切除术转为开放手术。术中出血（单支动脉组：4例，多支动脉组：1例）是转为开放手术的最常见原因。SA组和MA组分别有4例和1例患者出现术后泌尿系统并发症。两组供体的住院时间相似。两组患者在术后第7天、第30天、第90天和1年时的血清肌酐水平在统计学上相似。
经验丰富的手术团队发现，对于有多支肾动脉的供体，腹腔镜供肾切除术与单支肾动脉供体的手术一样安全。
