Normal variations of renal vessels based upon the study of 240 living-donor nephrectomies

Suh, Dong Hwan; Yang, Seung Chul

Abstract

A full understanding of the potential anatomical variations of the renal veins and its branches is imperative for donor nephrectomies. Preoperative renal angiography is the most important study to evaluate renal vascular anatomy. By this technique. the renal arteries are well visualized. but it is almost impossible to obtain the exact informations of the renal veins and its branches. To prevent extensive manipulation of the kidney by profuse bleeding. the exact information of the renal veins and its branches is very important. Based on intraoperative observation of 240 consecutive cases of donor nephrectomies. we observett. the common renal vein variants. Left renal veins usually had two branches; adrenal vein proximally and gonadal vein distally. Lumbar veins were identified in 112 cases(56.7%) Lumbar veins were connected to renal veins posteriorly near the draining site of gonadal veins. Therefore it is very important to dissect very carefully the posterior part of renal vein around the insertion of gonadal vein because of the existence of lumbar vein which might cause troublsome bleeding by accidental tearing. Especially when the cases of angulated renal veins were observed by renal angiography. the more attention will be required due to the strong possibility or the existence of lumbar vein.