Renovascular complications of laparoscopic donor nephrectomy.

摘要

OBJECTIVES: To review the operative renovascular injuries related to our laparoscopic donor nephrectomy experience, since management of intraoperative renovascular complications during laparoscopic nephrectomy can present a serious challenge. METHODS: During a 6-year period, 353 patients underwent laparoscopic donor nephrectomy. A retrospective chart review was performed to identify and evaluate the renovascular complications associated with the procedure. RESULTS: Eight cases (2.3%) of renovascular complications were identified. Vascular injury involved the renal artery in 6 cases and the renal vein in 2 cases. The etiologies included endovascular GIA stapling failure (n = 2), surgical clip dislodgment (n = 2), and vessel laceration during dissection or stapling (n = 4). Open conversion was necessary in 6 cases (75%). No patient mortality or allograft loss occurred. CONCLUSIONS: Laparoscopic donor nephrectomy is associated with a low incidence of renovascular complications. Laparoscopic or open surgical management may be required when problems arise to optimize donor safety and allograft survival.