Anatomical description of double left suprarenal vein and its implications on renal transplantation surgeries

Abstract

Introduction: Left suprarenal vein (LSRV) is a tributary of the left renal vein in more than 95% of the population. In a research carried out by Mas, Arango, Guzmán et al. (1987), the double suprarenal vein appeared on 2.7% of the 110 nephrectomies done. The suprarenal vein (SRV) was unique on the 34 bodies analyzed by Duques, Rodrigues, Silva Neto et al. (2002). Therefore, the anatomical variations of the LSRV are rare, but its study is a subject of clinic and surgical importance for renal transplants. The objective of this study was to describe the dissection of the double LSRV. Material and Methods: A caliper rule was used to measure the length of the studied veins. The dissection of the left kidney and adrenal was done according to standard technique. Results: The different origins and trajectories of the double LSRV (normal and variant), tributaries and left renal vein were verified. The normal LSRV measured 3 cm up to the renal vein whereas the variant SRV, with 7.5 cm and thinner, went out of the lateral suprarenal border, went down adjacent to the kidney face to end in the left renal vein around 1.8 cm distal to the first. Conclusions: The variant SRV showed double the normal length, lower diameter and difficult visualization in situ because of its trajectory between the superior pole of the kidney and the suprarenal anterior face. This trajectory evokes extra care during surgical procedures of renal transplantation, mostly to avoid hypotension and hypovolemia after SRV ligation.

Keywords

double left suprarenal vein - kidney transplantation - anatomical variation