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    Evaluation of the renal arteries of 2,144 living kidney donors using computed tomography angiography and comparison with intraoperative findings
    (Karger, 2020) Sarıer, Mehmet; Callioglu, Mehmet; Yuksel, Yucel; Duman, Enes; Emek, Mestan; Usta, Sibel Surmen
    Objectives:A carefully chosen and suitably prepared kidney donor is essential in living-donor kidney transplantation. Computed tomography angiography (CTA) is an effective imaging method for evaluating the renovascular morphology of donor candidates. The aim of this study was to evaluate renal artery variations in kidney donors using CTA and compare the findings with the number of arteries detected during laparoscopic donor nephrectomy.Materials and Methods:The study included 2,144 living donors who underwent pretransplant renovascular assessment using CTA and laparoscopic donor nephrectomy in our center between August 2012 and October 2018. The number of renal arteries to the donor kidney detected on CTA was compared with the number of arteries discovered intraoperatively.Results:The mean age of the 2,144 living kidney donors included in the study was 47.19 +/- 13.3 (18-87) years. According to CTA findings, 81.1% (n= 1,738) had a single renal artery, 17.2% (n= 369) had double renal arteries, 1.6% (n= 35) had triple renal arteries, and 0.1% (n= 2) had quadruple renal arteries. The same number of renal arteries were detected by CTA and in laparoscopic donor nephrectomy in 97.9% (n= 2,099) of the donors. In the other 2.1% (n= 45), fewer renal arteries were detected intraoperatively compared to their CTA findings. None of the donors included in the study had a greater number of renal arteries discovered during nephrectomy than by CTA.Conclusion:CTA is a highly accurate method for the evaluation of renovascular variations in donor candidates for living-donor kidney transplantation. However, it must be kept in mind that double or multiple renal artery variations may be detected on CTA in 18.9% of donor candidates.
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    Laparoscopic live donor nephrectomy: experience of high-volume center with 2,477 cases
    (2021) Ozturk, Sefa Alperen; Yuksel, Yucel; Erbis, Halil; Aliosmanoglu, İbrahim; Sarıer, Mehmet; Yayar, Ozlem; Yavuz, Havva Asuman; Demirbas, Alper
    Objective: Donors' health and safety are mandatory in the living-donor kidney transplantation procedure. Laparoscopic live donor nephrectomy (LLDN) provides an increase in donor numbers with its benefits and becomes a standard of care. We aimed to explain the results, complication rates, tips, and tricks of the largest number of LLDN case series ever performed in the literature. Materials and methods: Between August 2012 and December 2019, 2,477 live donor case files were analyzed retrospectively. Age, gender, hospitalization times, body mass index, warm ischemia times, operation times, numbers of arteries, side of the kidneys, and complications were noted. Results: 1,421 (57.4%) of 2,477 donors were female (p = 0.007). Operation times and warm ischemia times were found longer in right-sided LLDN and donors with multiple renal arteries (p = 0.046, <0.001, and <0.001, respectively). Obesity (BMI >30 kg/m2) did not affect warm ischemia times while prolonging the operation times (p = 0.013). Hospitalization times and numbers of complications were higher in obese donors. Conclusions: LLDN seems to be a reliable solution with fewer complications and higher satisfaction rates. We hope to illuminate the way with tips and trick points for beginner transplant surgeons based on the experience obtained from 2,477 LLDN cases.