Vascular Multiplicity Should Not Be a Contra-Indication for Live Kidney Donation and Transplantation |
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| Authors: | Jeffrey A. Lafranca Mark van Bruggen Hendrikus J. A. N. Kimenai Thi C. K. Tran Türkan Terkivatan Michiel G. H. Betjes Jan N. M. IJzermans Frank J. M. F. Dor |
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| Affiliation: | 1Department of Surgery, division of HPB & Transplant Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;2Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;UNIFESP Federal University of São Paulo, BRAZIL |
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| Abstract: | BackgroundWhether vascular multiplicity should be considered as contraindication and therefore ‘extended donor criterion’ is still under debate.MethodsData from all live kidney donors from 2006–2013 (n = 951) was retrospectively reviewed. Vascular anatomy as imaged by MRA, CTA or other modalities was compared with intraoperative findings. Furthermore, the influence of vascular multiplicity on outcome of donors and recipients was studied.ResultsIn 237 out of 951 donors (25%), vascular multiplicity was present. CTA had the highest accuracy levels regarding vascular anatomy assessment. Regarding outcome of donors with vascular multiplicity, warm ischemia time (WIT) and skin-to-skin time were significantly longer if arterial multiplicity (AM) was present (5.1 vs. 4.0 mins and 202 vs. 178 mins). Skin-to-skin time was significantly longer, and complication rates were higher in donors with venous multiplicity (203 vs. 180 mins and 17.2% vs. 8.4%). Outcome of renal transplant recipients showed a significantly increased WIT (30 vs. 26.7 minutes), higher rate of DGF (13.9% vs. 6.9%) and lower rate of BPAR (6.9% vs. 13.9%) in patients receiving a kidney with AM compared to kidneys with singular anatomy.ConclusionsWe conclude that vascular multiplicity should not be a contra-indication, since it has little impact on clinical outcome in the donor as well as in renal transplant recipients. |
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