open access

Vol 79, No 4 (2020)
Original article
Published online: 2019-12-20
Submitted: 2019-07-10
Accepted: 2019-09-16
Get Citation

Vascular variations of the kidney, retrospective analysis of computed tomography images of ninety-one laparoscopic donor nephrectomies, and comparison of computed tomography images with perioperative findings

M. F. Ferhatoğlu, E. Atli, A. Gürkan, A. Kebudi
DOI: 10.5603/FM.a2019.0135
·
Pubmed: 31886882
·
Folia Morphol 2020;79(4):786-792.

open access

Vol 79, No 4 (2020)
ORIGINAL ARTICLES
Published online: 2019-12-20
Submitted: 2019-07-10
Accepted: 2019-09-16

Abstract

Background: In this retrospective study, we aimed to determine the variations of kidney arteries and veins in kidney donor patients who underwent preoperative, computed tomography angiography (CTA).

Materials and methods: We analysed kidney CTA findings of 91 donor nephrectomy patients operated from July 2016 through December 2017. Demographics, vascular diameters, abnormalities, numbers, branching variations, routing variations of arteries, and veins were assessed according to CTA images. We also compared the radiological findings with perioperative findings. Two radiologists evaluated CTA images, and the same surgical team performed all donor nephrectomies by laparoscopic approach.

Results: Ninety-one of the 96 patients involved to study. Forty-six (50.5%) patients were female. Thirty-five (38.4%) of 91 cases had accessory arteries. Seven (7.6%) right, 1 (1.1%) left and 8 (8.7%) bilateral double hilar artery was observed on CTA. No statistically significant difference was observed in the evaluation of the side of accessory/polar arteries (p > 0.05), and in the evaluation of the distribution of arterial/venous variations according to perioperative findings (p > 0.05). However, in the evaluation of CTA images, we found that the diameter of the kidney artery and vein differed according to gender and side.

Conclusions: The knowledge of the vascular variations of the kidney is essential for surgeons performing kidney transplantation. It is also essential for urologist and vascular surgeons. Incompatible with the literature, the right kidney has more vascular variations and, one kidney artery is found in the majority of Turkish kidney
donor patients.

Abstract

Background: In this retrospective study, we aimed to determine the variations of kidney arteries and veins in kidney donor patients who underwent preoperative, computed tomography angiography (CTA).

Materials and methods: We analysed kidney CTA findings of 91 donor nephrectomy patients operated from July 2016 through December 2017. Demographics, vascular diameters, abnormalities, numbers, branching variations, routing variations of arteries, and veins were assessed according to CTA images. We also compared the radiological findings with perioperative findings. Two radiologists evaluated CTA images, and the same surgical team performed all donor nephrectomies by laparoscopic approach.

Results: Ninety-one of the 96 patients involved to study. Forty-six (50.5%) patients were female. Thirty-five (38.4%) of 91 cases had accessory arteries. Seven (7.6%) right, 1 (1.1%) left and 8 (8.7%) bilateral double hilar artery was observed on CTA. No statistically significant difference was observed in the evaluation of the side of accessory/polar arteries (p > 0.05), and in the evaluation of the distribution of arterial/venous variations according to perioperative findings (p > 0.05). However, in the evaluation of CTA images, we found that the diameter of the kidney artery and vein differed according to gender and side.

Conclusions: The knowledge of the vascular variations of the kidney is essential for surgeons performing kidney transplantation. It is also essential for urologist and vascular surgeons. Incompatible with the literature, the right kidney has more vascular variations and, one kidney artery is found in the majority of Turkish kidney
donor patients.

Get Citation

Keywords

accessory, supernumerary, computed tomography, nephrectomy, vascular, variation, radiology, kidney transplantation

About this article
Title

Vascular variations of the kidney, retrospective analysis of computed tomography images of ninety-one laparoscopic donor nephrectomies, and comparison of computed tomography images with perioperative findings

Journal

Folia Morphologica

Issue

Vol 79, No 4 (2020)

Article type

Original article

Pages

786-792

Published online

2019-12-20

DOI

10.5603/FM.a2019.0135

Pubmed

31886882

Bibliographic record

Folia Morphol 2020;79(4):786-792.

Keywords

accessory
supernumerary
computed tomography
nephrectomy
vascular
variation
radiology
kidney transplantation

Authors

M. F. Ferhatoğlu
E. Atli
A. Gürkan
A. Kebudi

References (34)
  1. Bayazit M, Göl MK, Zorlutuna Y, et al. Bilateral triple renal arteries in a patient with iliac artery occlusion: a case report. Surg Radiol Anat. 1992; 14(1): 81–83.
  2. Bordei P, Sapte E, Iliescu D. Double renal arteries originating from the aorta. Surg Radiol Anat. 2004; 26(6): 474–479.
  3. Choi KH, Yang SC, Lee SR, et al. Standardized video-assisted retroperitoneal minilaparotomy surgery for 615 living donor nephrectomies. Transpl Int. 2011; 24(10): 973–983.
  4. Ciçekcibaşi AE, Ziylan T, Salbacak A, et al. An investigation of the origin, location and variations of the renal arteries in human fetuses and their clinical relevance. Ann Anat. 2005; 187(4): 421–427.
  5. Cochran ST, Krasny RM, Danovitch GM, et al. Helical CT angiography for examination of living renal donors. Am J Roentgenol. 1997; 168(6): 1569–1573.
  6. Dachman AH, Newmark GM, Mitchell MT, et al. Helical CT examination of potential kidney donors. Am J Roentgenol. 1998; 171(1): 193–200.
  7. Del Pizzo JJ, Sklar GN, You-Cheong JW, et al. Helical computerized tomography arteriography for evaluation of live renal donors undergoing laparoscopic nephrectomy. J Urol. 1999; 162(1): 31–34.
  8. Dogra A, Chauhan RS, Sharma S, et al. Variations of renal arteries on 64 slice multidetector computed tomography. J Anat Soc India. 2017; 66(1): 20–25.
  9. Goyal N, Bala A, Batra APS, et al. Variations in branching pattern of renal vessels. Int J Sci Res. 2017; 9: 1–3.
  10. Gulas E, Wysiadecki G, Szymański J, et al. Morphological and clinical aspects of the occurrence of accessory (multiple) renal arteries. Arch Med Sci. 2018; 14(2): 442–453.
  11. Gurkan A, Varilsuha C, Eren S, et al. Renal transplant vericilerinin saptanmasında spiral bilgisayarlı tomografik angiografinin değeri. Klinik ve Deneysel Cerrahi Dergisi. 2000; 8: 190–193.
  12. Hung CJ, Lin YJ, Chang SS, et al. Kidney grafts with multiple renal arteries is no longer a relative contraindication with advance in surgical techniques of laparoscopic donor nephrectomy. Transplant Proc. 2012; 44(1): 36–38.
  13. Jimenez R, Morant F. The importance of venous and renal anomalies for surgical repair of abdominal aortic aneurysms. Grundmann R (Ed). Diagnosis, Screening and Treatment of Abdominal, Thoracoabdominal and Thoracic Aortic Aneurysms. United Kingdom, London InTech publishing. 2011: 269–292.
  14. Kaynan AM, Rozenblit AM, Figueroa KI, et al. Use of spiral computerized tomography in lieu of angiography for preoperative assessment of living renal donors. J Urol. 1999; 161(6): 1769–1775.
  15. Khamanarong K, Prachaney P, Utraravichien A, et al. Anatomy of renal arterial supply. Clin Anat. 2004; 17(4): 334–336.
  16. Kumar S, Neyaz Z, Gupta A. The utility of 64 channel multidetector CT angiography for evaluating the renal vascular anatomy and possible variations: a pictorial essay. Korean J Radiol. 2010; 11(3): 346–354.
  17. Kumar U, Prabha R. Study of prehilar branching pattern of renal artery in human cadaveric kidneys. Nat J Clin Anat. 2016; 5(2): 86–90.
  18. Majos M, Stefańczyk L, Szemraj-Rogucka Z, et al. Does the type of renal artery anatomic variant determine the diameter of the main vessel supplying a kidney? A study based on CT data with a particular focus on the presence of multiple renal arteries. Surg Radiol Anat. 2018; 40(4): 381–388.
  19. Merklin RJ, Michels NA. The variant renal and suprarenal blood supply with data on the inferior phrenic, ureteral and gonadal arteries: a statistical analysis based on 185 dissections and review of the literature. J Int Coll Surg. 1958; 29(1 Pt 1): 41–76.
  20. Ozkan U, Oğuzkurt L, Tercan F, et al. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol. 2006; 12(4): 183–186.
  21. Platt JF, Ellis JH, Korobkin M, et al. Helical CT evaluation of potential kidney donors: findings in 154 subjects. Am J Roentgenol. 1997; 169(5): 1325–1330.
  22. Pozniak MA, Balison DJ, Lee FT, et al. CT angiography of potential renal transplant donors. Radiographics. 1998; 18(3): 565–587.
  23. Rao N, Kishore K, K S, et al. Extra hilar branching of renal arteries: An anatomical study. Int J Anat Res. 2015; 3(4): 1568–1572.
  24. Roi GS, Mosconi G, Totti V, et al. Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients. World J Transplant. 2018; 8(1): 13–22.
  25. Saldarriaga B, Pérez AF, Ballesteros LE. A direct anatomiclal study of additional renal arteries in a Colombian mestizo population. Folia Morphol. 2008; 67: 129–134.
  26. Sampaio FJ, Passos MA. Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat. 1992; 14(2): 113–117.
  27. Saritha S, Jyothi N, Kumar M, et al. Cadaveric study of accessory renal arteries and its surgical correlation. Int J Res Med Scien. 2013; 1(1): 19–22.
  28. Satyapal KS, Haffejee AA, Singh B, et al. Additional renal arteries: incidence and morphometry. Surg Radiol Anat. 2001; 23(1): 33–38.
  29. Shakeri AB, Tubbs RS, Shoja MM, et al. Bipolar supernumerary renal artery. Surg Radiol Anat. 2007; 29(1): 89–92.
  30. Slakey DP, Florman S, Lovretich J, et al. Utility of CT angiography for evaluation of living kidney donors. Clin Transplant. 1999; 13(1 Pt 2): 104–107.
  31. Sośnik H, Sośnik K. Renal vascularisation anomalies in the Polish population. Coexistence of arterial and venous anomalies in the vascular pedicle of the kidney. Folia Morphol. 2019; 78(2): 290–296.
  32. Staśkiewicz G, Jajko K, Torres K, et al. Supernumerary renal vessels: analysis of frequency and configuration in 996 computed tomography studies. Folia Morphol. 2016; 75(2): 245–250.
  33. Uday DP, Ragavan A, Murthy K, et al. Helical CT angiography in evaluation of live kidney donors. Nephrol Dial Transplant. 2001; 16(9): 1900–1904.
  34. Weld KJ, Bhayani SB, Belani J, et al. Extrarenal vascular anatomy of kidney: assessment of variations and their relevance to partial nephrectomy. Urology. 2005; 66(5): 985–989.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl