Crane Catherine, Lam Vincent W T, Alsakran Abdulrahman, Vasilaras Arthur, Lau Howard, Ryan Brendan, Pleass Henry C C, Allen Richard D M
Discipline of Surgery, University of Sydney Department of Surgery, Westmead Hospital Transplantation Services, Royal Prince Alfred Hospital, Sydney, Australia.
ANZ J Surg. 2010 Nov;80(11):781-5. doi: 10.1111/j.1445-2197.2010.05439.x. Epub 2010 Aug 19.
The aim of this study was to analyse the effect of the right donor kidney and multiple arteries, on donor and recipient outcomes in the era of laparoscopic live donor nephrectomy (LLDN).
e retrospectively analysed the 200 donors and recipients who underwent a planned laparoscopic nephrectomy at two hospitals between September 1998 and December 2006. The impact of donor right kidney and multiple donor renal arteries on operative time, hospital stay, graft function, and donor and recipient complications were analysed.
Of the total cohort (n=200), 140 (70%) were classified as Simple LLDN (left live donor kidney with single renal artery). The Complex LLDN group (n=60) contained all right-sided kidney (n=28) and left-sided kidneys with multiple renal arteries (n=32). Baseline characteristics, extraction time, conversion to open, length of admission, overall graft function and complication rates were similar between the simple and complex groups. The second warm ischaemic time in the Simple LLDN group was slightly shorter than the Complex LLDN group (32 versus 36 min P=0.016). The 1-month post-operative recipient serum creatinine level was lower in the Simple LLDN group when compared with the Complex LLDN group (117 versus 125 µmol/L P=0.025). There was no difference in post op dialysis, acute rejection within 3 months or graft survival between the Simple and Complex LLDN groups.
Laparoscopic procurements of right kidneys and kidneys with multiple arteries were safe and yielded kidneys with excellent function comparable with those of laparoscopic left donor nephrectomy with single artery.
本研究旨在分析在腹腔镜活体供肾切除术（LLDN）时代，供体右肾及多支动脉对供体和受体结局的影响。
我们回顾性分析了1998年9月至2006年12月期间在两家医院接受计划性腹腔镜肾切除术的200例供体和受体。分析了供体右肾和多支供体肾动脉对手术时间、住院时间、移植肾功能以及供体和受体并发症的影响。
在整个队列（n = 200）中，140例（70%）被归类为简单LLDN（左活体供肾，单支肾动脉）。复杂LLDN组（n = 60）包括所有右侧肾脏（n = 28）和左侧多支肾动脉的肾脏（n = 32）。简单组和复杂组之间的基线特征、摘取时间、中转开腹、住院时间、总体移植肾功能和并发症发生率相似。简单LLDN组的第二次热缺血时间略短于复杂LLDN组（32分钟对36分钟，P = 0.016）。与复杂LLDN组相比，简单LLDN组术后1个月受体血清肌酐水平较低（117对125 μmol/L，P = 0.025）。简单LLDN组和复杂LLDN组在术后透析、3个月内急性排斥反应或移植肾存活方面无差异。
腹腔镜摘取右肾和多支动脉的肾脏是安全的，所获肾脏功能良好，与腹腔镜单支动脉左供肾切除术相当。
