Şahin Selçuk, Özdemir Osman, Ekşi Mithat, Evren İsmail, Karadağ Serdar, Arikan Yusuf, Taşçı Ali İhsan
Department of Urology, University of Health Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Ir J Med Sci. 2023 Apr;192(2):929-934. doi: 10.1007/s11845-022-03024-8. Epub 2022 Jun 13.
As the number of end-stage renal disease (ESRD) patients is increasing, but there are not enough living donors, it is necessary to broaden the criteria for candidates who can undergo donor nephrectomy. Thanks to surgeons' increasing experience with laparoscopic donor nephrectomy (LND), multiple renal artery grafts, previously considered a relative contraindication to donor nephrectomy, have become candidates for LDN. We aimed to compare the outcomes of donors and recipients with single artery and with multiple arteries in LDN.
A total of 214 patients were included in the study. Patients were divided into two groups according to the number of donor arteries: donors with one artery (group 1) and donors with multiple arteries (group 2). The number of donor arteries, operative time, warm ischemia time (WIT), cold ischemia time (CIT), arterial anastomosis time, venous anastomosis time, the extent of bleeding, and preoperative complications were recorded to evaluate the preoperative data.
The mean operation time in group 1 was 90.3 ± 11.8 min, while in group 2, it was 102.1 ± 5.5 min (p = 0.000). WIT group 1 was 90.9 ± 4.3 s and group 2 100.6 ± 2.1 s (p = 0.000). Arterial anastomosis time was 12.25 ± 3.8 in group 1 and 22.5 ± 4.5 in group 2 (p = 0.000). No statistically significant difference was found between the two groups in other parameters.
Increasing the number of donor arteries in renal transplantation (RT) operations prolonged the operation time on both the donor and recipient sides. Still, it had no negative impact on complications or graft function in the postoperative period.
随着终末期肾病（ESRD）患者数量的增加，但活体供体不足，有必要扩大可接受供肾切除术的候选标准。由于外科医生在腹腔镜供肾切除术（LND）方面的经验不断增加，以前被认为是供肾切除术相对禁忌证的多支肾动脉移植物，已成为LDN的候选对象。我们旨在比较LDN中单一动脉和多支动脉供体及受体的结局。
本研究共纳入214例患者。根据供体动脉数量将患者分为两组：单支动脉供体（第1组）和多支动脉供体（第2组）。记录供体动脉数量、手术时间、热缺血时间（WIT）、冷缺血时间（CIT）、动脉吻合时间、静脉吻合时间、出血量及术前并发症，以评估术前数据。
第1组平均手术时间为90.3±11.8分钟，而第2组为102.1±5.5分钟（p = 0.000）。第1组WIT为90.9±4.3秒，第2组为100.6±2.1秒（p = 0.000）。第1组动脉吻合时间为12.25±3.8，第2组为22.5±4.5（p = 0.000）。两组在其他参数上未发现统计学显著差异。
肾移植（RT）手术中供体动脉数量增加会延长供体和受体双方的手术时间。不过，对术后并发症或移植物功能没有负面影响。
