Surgical aspects and the outcomes of kidney transplants with multiple renal arteries

Abstract

Introduction: The effect of multiple arterial anastomosis and different reconstruction techniques on the outcome of renal transplant recipients is not clearly defined. In this retrospective study, we report our experience of living donor kidney transplantation using allografts with multiple renal arteries, regarding the patient and graft survival, as well as surgical complications. Materials and Methods: Patients were divided into two groups according to the arterial anatomy of the renal allograft. While group I consisted of patients with single renal artery grafts, group II included patients with multiple renal artery grafts. Results were compared between single and multiple artery groups and further analyzed between the groups, which were constituted according to vascular reconstruction technique. Results: Forty-five patients (15.7%) had grafts with multiple renal arteries. The mean total ischemia time was longer in multiple renal artery group (90.8±17.3 vs. 71.9±16.6 minutes, p<0.001). The mean serum creatinine level at posttransplant one year was significantly higher in multiple artery group than in single renal artery group (1.74±0.45 vs.1.46±44 mg/dl), but it was similar at fifth year. There was no significant difference between the groups with regard to mean systolic blood pressure, the incidence of acute tubular necrosis and acute rejection, vascular and urological complications, graft and patient survival rates. Similar findings were obtained in patients with multiple arteries whose anastomosis were performed with different reconstruction techniques. Conclusion: Our data shows that transplantation of the kidney with multiple arteries is safe. Any reconstruction technique can be chosen according to the vascular anatomy of the graft and the recipient.