Anatomical variations of the renal artery: a computerized tomographic angiogram study in living kidney donors at a Nigerian Kidney Transplant Center

Background: Understanding of the renal vascular anatomy is key to a safe and successful donor nephrectomy, which ulti- mately impacts on the renal graft function and survival in kidney transplant recipients. Objective: To report the various anatomical configurations of the renal artery identified in living kidney donors in a Nige- rian kidney transplant institution . Materials and Methods: The computerized tomography angiograms of 100 consecutive living kidney donors were pro- spectively reviewed over an 18-month period. Anatomical variations of the renal arteries including accessory arteries and early divisions were noted. Duration of surgery and ischemic time were recorded intra-operatively. Data analysis was carried out using IBM SPSS version 20. Results: There were variations in renal artery configuration in 50 (50%) cases, 32% were accessory renal arteries while 18% were early branches of the renal artery. The classical bilateral solitary renal arteries were found in 50 (50%) of potential do- nors. There was statistically significant longer operating and ischemic time in donors with multiple renal arteries as compared with solitary arteries (p<0.05). Conclusion: There are a wide variety of renal artery configurations seen in potential kidney donors. The classical solitary renal artery remains the commonest and most favourable configuration for donor nephrectomy and transplantation. Keywords: Renal artery; variations; living kidney donors.

Download Full-text

The Association between Body Composition Measurements and Surgical Complications after Living Kidney Donation

Journal of Clinical Medicine ◽

10.3390/jcm10010155 ◽

2021 ◽

Vol 10 (1) ◽

pp. 155

Author(s):

Lisa B. Westenberg ◽

Marco van Londen ◽

Camilo G. Sotomayor ◽

Cyril Moers ◽

Robert C. Minnee ◽

...

Keyword(s):

Body Composition ◽

Logistic Regression ◽

Postoperative Complications ◽

Surgical Complications ◽

Donor Nephrectomy ◽

Regression Analyses ◽

Kidney Donors ◽

Living Kidney Donors ◽

Binomial Logistic Regression ◽

Duration Of Surgery

Obesity is considered a risk factor for peri- and postoperative complications. Little is known about this risk in overweight living kidney donors. The aim of this study was to assess if anthropometric body measures and/or surgical determinants are associated with an increased incidence of peri- and postoperative complications after nephrectomy. We included 776 living kidney donors who donated between 2008 and 2018 at the University Medical Center Groningen. Prenephrectomy measures of body composition were body mass index (BMI), body surface area (BSA), waist circumference, weight, and waist–hip ratio. Incidence and severity of peri- and postoperative complications were assessed using the Comprehensive Complication Index. Mean donor age was 53 ± 11 years; 382 (49%) were male, and mean BMI at donor screening was 26.2 ± 3.41 kg/m2. In total, 77 donors (10%) experienced peri- and postoperative complications following donor nephrectomy. Male sex was significantly associated with fewer surgical complications (OR 0.59, 0.37–0.96 95%CI, p = 0.03) in binomial logistic regression analyses. Older age (OR: 1.03, 1.01–1.05 95%CI, p = 0.02) and a longer duration of surgery (OR: 1.01, 1.00–1.01 95%CI, p = 0.02) were significantly associated with more surgical complications in binomial logistic regression analyses. Multinomial logistic regression analyses did not identify any prenephrectomy measure of body composition associated with a higher risk of surgical complications. This study shows that higher prenephrectomy BMI and other anthropometric measures of body composition are not significantly associated with peri- and postoperative complications following living donor nephrectomy.

Download Full-text