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Incidence of Ureteral Strictures After Laparoscopic Donor Nephrectomy

2006; Lippincott Williams & Wilkins; Volume: 176; Issue: 3 Linguagem: Inglês

10.1016/j.juro.2006.04.079

1527-3792

Alberto Breda, Matthew Bui, Joseph C. Liao, H. Albin Gritsch, Peter G. Schulam,

Renal and Vascular Pathologies

No AccessJournal of UrologyAdult urology1 Sep 2006Incidence of Ureteral Strictures After Laparoscopic Donor Nephrectomy Alberto Breda, Matthew H. Bui, Joseph C. Liao, H. Albin Gritsch, and Peter G. Schulam Alberto BredaAlberto Breda , Matthew H. BuiMatthew H. Bui , Joseph C. LiaoJoseph C. Liao , H. Albin GritschH. Albin Gritsch , and Peter G. SchulamPeter G. Schulam View All Author Informationhttps://doi.org/10.1016/j.juro.2006.04.079AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Previous reports of laparoscopic donor nephrectomy have suggested that preservation of the gonadal vein with the specimen is important for preventing ureteral strictures. To test this hypothesis we examined our series of patients for the incidence of ureteral strictures when the gonadal vein was not preserved with the specimen during laparoscopic donor nephrectomy. Materials and Methods: We reviewed the records of 300 consecutive patients at our institution who underwent laparoscopic donor nephrectomy between 2000 and 2005. Mean donor age was 36.7 years (range 18 to 68) in the 167 female and 133 male donors. Mean recipient age was 38.4 years. Average followup was 2 years. During ureteral dissection the gonadal vein was transected just distal to the renal vein and left in situ. The ureter was dissected and transected at the level of the common iliac vessels. Indwelling ureteral stents were used for all recipient ureteral reimplantations and left in place for 1 month. In the postoperative period transplant recipients were followed biweekly for serum creatinine function during month 1 and monthly thereafter. All patients with increased creatinine (greater than 1.3 mg/dl) or an increasing trend were evaluated with transplant renal ultrasound. Clinically significant ureteral stricture was defined as persistent hydronephrosis resulting in impaired renal function and the need for percutaneous nephrostomy tube placement or ureteroscopic management. Results: After laparoscopic living donor transplantation without gonadal vein preservation we found no incidence of clinically significant ureteral stricture. Conclusions: Gonadal vein preservation with the specimen during laparoscopic donor nephrectomy is not necessary. Preservation of the periureteral blood supply is sufficient to prevent ureteral strictures. References 1 : Laparoscopic live donor nephrectomy. Transplantation1995; 60: 1047. Medline, Google Scholar 2 United States Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients Annual Report 1991–2000. 2001 Google Scholar 3 : Laparoscopic assisted live donor nephrectomy—a comparison with the open approach. Transplantation1997; 63: 229. 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Google Scholar Department of Urology, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California© 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byHarper J, Breda A, Leppert J, Veale J, Gritsch H and Schulam P (2010) Experience With 750 Consecutive Laparoscopic Donor Nephrectomies—Is it Time to Use a Standardized Classification of Complications?Journal of Urology, VOL. 183, NO. 5, (1941-1946), Online publication date: 1-May-2010. Volume 176Issue 3September 2006Page: 1065-1068 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsureteral strictureskidney transplantationlaparoscopynephrectomykidneyMetricsAuthor Information Alberto Breda More articles by this author Matthew H. Bui More articles by this author Joseph C. Liao More articles by this author H. Albin Gritsch More articles by this author Peter G. Schulam More articles by this author Expand All Advertisement PDF downloadLoading ...