Is the Reluctance for the Implantation of Right Donor Kidneys Justified?

• Published in: World journal of surgery 2016-02, Vol.40 (2), p.471-478
• Main Authors: Özdemir-van Brunschot, Denise M. D., van Laarhoven, Cees J. H. M., van der Jagt, Michel F. P., Hoitsma, Andries J., Warlé, Michiel C.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Cardiac Surgery; Female; General Surgery; Graft Failure; Graft Survival; Humans; Kidney - blood supply; Kidney - surgery; Kidney Transplantation - adverse effects; Kidney Transplantation - methods; Left Kidney; Living Donors; Male; Medicine; Medicine & Public Health; Middle Aged; Netherlands; Organ Size; Original Scientific Report; Registries; Renal Allograft; Renal Vein; Renal Veins - anatomy & histology; Surgery; Technical Failure; Thoracic Surgery; Transplant Donor Site - anatomy & histology; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-015-3232-0

Background The lengths of right renal veins are shorter when compared to their left counterparts. Since the implantation of kidneys with short renal veins is considered more challenging, many surgeons prefer left kidneys for transplantation. Therefore, our hypothesis is that the implantation of right kidneys from living and deceased donors is associated with more technical graft failures as compared to left kidneys. Methods Two consecutive cohorts of adult renal allograft recipients of living ( n  = 4.372) and deceased ( n  = 5.346) donor kidneys between January 1, 2000 and January 1, 2013 were analyzed. Data were obtained from the prospectively maintained electronic database of the Dutch Organ Transplant Registry. Technical graft failure was defined as failure of the renal allograft within 10 days after renal transplantation without signs of acute rejection. Results In the living donor kidney transplantation cohort, the implantation of right donor kidneys was associated with a higher incidence of technical graft failure (multivariate analysis p  = 0.03). For recipients of deceased donor kidneys, the implantation of right kidneys was not significantly associated with technique-related graft failure (multivariate analysis p  = 0.16). Conclusions Our data show that the implantation of right kidneys from living donors is associated with a higher incidence of technique-related graft failure as compared to left kidneys.