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Open Access 01-02-2016 | Original Scientific Report

Is the Reluctance for the Implantation of Right Donor Kidneys Justified?

Authors: Denise M. D. Özdemir-van Brunschot, Cees J. H. M. van Laarhoven, Michel F. P. van der Jagt, Andries J. Hoitsma, Michiel C. Warlé

Published in: World Journal of Surgery | Issue 2/2016

Abstract

Background

The lengths of right renal veins are shorter when compared to their left counterparts. Since the implantation of kidneys with short renal veins is considered more challenging, many surgeons prefer left kidneys for transplantation. Therefore, our hypothesis is that the implantation of right kidneys from living and deceased donors is associated with more technical graft failures as compared to left kidneys.

Methods

Two consecutive cohorts of adult renal allograft recipients of living (n = 4.372) and deceased (n = 5.346) donor kidneys between January 1, 2000 and January 1, 2013 were analyzed. Data were obtained from the prospectively maintained electronic database of the Dutch Organ Transplant Registry. Technical graft failure was defined as failure of the renal allograft within 10 days after renal transplantation without signs of acute rejection.

Results

In the living donor kidney transplantation cohort, the implantation of right donor kidneys was associated with a higher incidence of technical graft failure (multivariate analysis p = 0.03). For recipients of deceased donor kidneys, the implantation of right kidneys was not significantly associated with technique-related graft failure (multivariate analysis p = 0.16).

Conclusions

Our data show that the implantation of right kidneys from living donors is associated with a higher incidence of technique-related graft failure as compared to left kidneys.

Ratner LE et al (1995) Laparoscopic live donor nephrectomy. Transplantation 60(9):1047–1049PubMed

Klop KW et al (2012) Attitudes among surgeons towards live-donor nephrectomy: a European update. Transplantation 94(3):263–268PubMedCrossRef

Wilson CH et al (2011) Laparoscopic versus open nephrectomy for live kidney donors. Cochrane Database Syst Rev (11):CD006124. doi:10.1002/14651858.CD006124.pub2

Ratner LE et al (1998) Laparoscopic live donor nephrectomy: technical considerations and allograft vascular length. Transplantation 65(12):1657–1658PubMedCrossRef

Mandal AK et al (2001) Should the indications for laparoscopic live donor nephrectomy of the right kidney be the same as for the open procedure? Anomalous left renal vasculature is not a contraindication to laparoscopic left donor nephrectomy. Transplantation 71(5):660–664PubMedCrossRef

Ko EY et al (2008) Utility of the endovascular stapler for right-sided laparoscopic donor nephrectomy: a 7-year experience at Mayo Clinic. J Am Coll Surg 207(6):896–903PubMedCrossRef

Bettschart V et al (2003) Laparoscopic right nephrectomy for live kidney donation: functional results. Transpl Int 16(6):419–424PubMedCrossRef

Posselt AM et al (2004) Laparoscopic right donor nephrectomy: a large single-center experience. Transplantation 78(11):1665–1669PubMedCrossRef

Dols LF et al (2009) Laparoscopic donor nephrectomy: a plea for the right-sided approach. Transplantation 87(5):745–750PubMedCrossRef

10.

Cheng EY et al (2010) Outcomes of laparoscopic donor nephrectomy without intraoperative systemic heparinization. J Urol 183(6):2282–2286PubMedCrossRef

11.

Boorjian S et al (2004) Right laparoscopic live donor nephrectomy: a single institution experience. Transplantation 77(3):437–440PubMedCrossRef

12.

Maartense S et al (2004) Hand-assisted laparoscopic live donor nephrectomy. Br J Surg 91(3):344–348PubMedCrossRef

13.

Lind MY et al (2002) Right-sided laparoscopic live-donor nephrectomy: is reluctance still justified? Transplantation 74(7):1045–1048PubMedCrossRef

14.

Gures N et al (2013) Comparison of the right and left laparoscopic live donor nephrectomies: a clinical case load. Eur Rev Med Pharmacol Sci 17(10):1389–1394PubMed

15.

Liu N et al (2014) Maximizing the donor pool: left versus right laparoscopic live donor nephrectomy—systematic review and meta-analysis. Int Urol Nephrol 46(8):1511–1519PubMedCrossRef

16.

Amezquita Y et al (2008) Risk factors for early renal graft thrombosis: a case-controlled study in grafts from the same donor. Transplant Proc 40(9):2891–2893PubMedCrossRef

17.

Bakir N et al (1996) Primary renal graft thrombosis. Nephrol Dial Transplant 11(1):140–147PubMedCrossRef

18.

Vacher-Coponat H et al (2013) Inferior early posttransplant outcomes for recipients of right versus left deceased donor kidneys: an ANZDATA registry analysis. Am J Transplant 13(2):399–405PubMedCrossRef

19.

Englesbe MJ et al (2004) Single-center study of technical graft loss in 714 consecutive renal transplants. Transplantation 78(4):623–626PubMedCrossRef

20.

Samhan M, Sinan T, Al-Mousawi M (1999) Vascular complications in renal recipients. Transplant Proc 31(8):3227–3228PubMedCrossRef

21.

Nagra A et al (2004) The effect of heparin on graft thrombosis in pediatric renal allografts. Pediatr Nephrol 19(5):531–535PubMedCrossRef

22.

Phelan PJ et al (2009) Left versus right deceased donor renal allograft outcome. Transpl Int 22(12):1159–1163PubMedCrossRef

23.

Salehipour M et al (2008) Comparison of right and left grafts in renal transplantation. Saudi J Kidney Dis Transplant 19(2):222–226

24.

Roodnat JI et al (2003) Ischemia times and donor serum creatinine in relation to renal graft failure. Transplantation 75(6):799–804PubMedCrossRef

25.

Yarlagadda SG et al (2008) Marked variation in the definition and diagnosis of delayed graft function: a systematic review. Nephrol Dial Transplant 23(9):2995–3003PubMedPubMedCentralCrossRef

26.

Chedid MF et al (2013) Living donor kidney transplantation using laparoscopically procured multiple renal artery kidneys and right kidneys. J Am Coll Surg 217(1):144–152 (discussion 152) PubMedCrossRef

27.

Bachir BG et al (2011) Evaluation of right versus left laparoscopic donor nephrectomy. Exp Clin Transplant 9(5):310–314PubMed

28.

Keller AK, Jorgensen TM, Jespersen B (2012) Identification of risk factors for vascular thrombosis may reduce early renal graft loss: a review of recent literature. J Transplant 2012:793461PubMedPubMedCentral

29.

Salehipour M et al (2009) Vascular complications following 1500 consecutive living and cadaveric donor renal transplantations: a single center study. Saudi J Kidney Dis Transplant 20(4):570–572

30.

Emiroglu R et al (2001) Vascular complications in renal transplantation. Transplant Proc 33(5):2685–2686PubMedCrossRef

31.

Phelan PJ et al (2012) Renal allograft loss in the first post-operative month: causes and consequences. Clin Transplant 26(4):544–549PubMedCrossRef

32.

Aktas S et al (2011) Analysis of vascular complications after renal transplantation. Transplant Proc 43(2):557–561PubMedCrossRef

Title: Is the Reluctance for the Implantation of Right Donor Kidneys Justified?
Authors: Denise M. D. Özdemir-van Brunschot
Cees J. H. M. van Laarhoven
Michel F. P. van der Jagt
Andries J. Hoitsma
Michiel C. Warlé
Publication date: 01-02-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 2/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3232-0

ACC 2024 Congress

Springer Medicine

Is the Reluctance for the Implantation of Right Donor Kidneys Justified?

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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