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  • Title: Anatomical Variations of the Left Renal Vein During Laparoscopic Donor Nephrectomy.
    Author: Tatarano S, Enokida H, Yamada Y, Nishimura H, Yoshino H, Ishihara T, Yonemori M, Eura R, Sakaguchi T, Nakagawa M.
    Journal: Transplant Proc; 2019 Jun; 51(5):1311-1313. PubMed ID: 31036354.
    Abstract:
    OBJECTIVES: The aim of this study is to investigate the outcome of laparoscopic donor nephrectomy with vascular anomalies of the left renal vein. PATIENTS AND METHODS: Between August 2010 and September 2018, a total of 120 laparoscopic donor nephrectomies were performed at Kagoshima University. Among them, we experienced 7 cases of donors with anomalous left renal vein (circumaortic left renal vein n = 5, retroaortic left renal vein n = 1, left renal vein drainage into hemiazygos vein n = 1). We analyzed the following clinical outcomes: pneumoperitoneum time, estimated blood loss, warm ischemia time, length of hospital stay, and serum creatinine level of 1 month after surgery for evaluating the safety of laparoscopic donor nephrectomy. RESULTS: Among the 7 cases, 3 cases underwent transperitoneal approach, and 4 cases underwent retroperitoneal approach. The median pneumoperitoneum time was 168 (108-191) minutes. The median estimated blood loss was 90 (23-170) mL, and no donor required a blood transfusion. Median warm ischemia time was 4 (3-7) minutes. Length of hospital stay was 7 (6-9) days, and no readmission occurred. Median serum creatinine level of 1 month after surgery was 1.19 (0.84-1.74) mg/dL. Kidneys were transplanted successfully, and none of recipients required dialysis. CONCLUSIONS: Laparoscopic donor nephrectomy was safe for donors with an anomalous left renal vein. Preoperative recognition of anomalous left renal vein in computed tomography is important for avoiding hemorrhagic complication.
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