Association of Live Donor Nephrectomy and Reversal of Renal Artery Spasm

Background: Kidney transplantation is the best treatment option for kidney failure. Major medical progress has been made in the field of renal transplantation over the last 40 years. The surgical procedure has been standardized and the complication rate is low. Overall, the outcome of renal transplantation is excellent and has improved over time. Vascular complications after renal transplantation are the most frequent type of complication following urological complications. Renal artery spasm (RAS) following manipulation of renal artery is a common problem during live donor nephrectomy (LDN). The aim of this study was to determine whether or not it is necessary to wait for reverse of RAS and resumption of urinary flow before nephrectomy.

Patients and Methods: In this clinical trial 16 cases of LDN who developed RAS during surgery received intra-arterial injection of 40 mg papaverine. In 8 cases surgery continued towards nephrectomy and in other 8 cases we waited for reverse of RAS. All analyses were performed using SPSS-11.

Results: In both groups urinary flow started a few minutes (Mean, 12 min) after declamping of transplanted kidney and normal renal consistency and color were achieved. There was no significant difference between urinary volumes during 12 h after transplantation in two groups.

Conclusions: The results showed that it might not be necessary to wait for reverse of RAS before LDN. Both patient (less anesthesia complications) and hospital (less expenses) will benefit from this time saving.