Surgical approach to cases with multiple renal arteries in renal transplantation

To evaluate the effect of multiple renal artery (MRA) presence on the success and complication rate of renal allotransplantation.

We retrospectively analyzed 187 cases (128 men and 59 women) who were transplanted in our department from 1997 to 2005. 28 of these cases had MRA. Of MRA kidneys, 6 were obtained from cadavers and 22 from live donors. When the types of anastomoses for MRA cases were examined, 4 cases were anastomosed after being connected to the main polar artery with ex vivo bench surgery; the others had in vivo anastomosis. The patients were divided into two groups as single (group 1) and MRA (group 2) groups. Following the transplantation, creatinine levels, ATN ratios, development of hypertension, patient and graft survivals and vascular and urological complications were compared between the two groups.

Patient and graft survival rates were compared between the two groups in the first and third post-operative years. In the first year, graft survival rates for groups 1 and 2 were 94.9 and 92.9% respectively, whereas in the third year these were calculated as 88 and 85.7%. Concerning patient survival, first year results for groups 1 and 2 were 92.5 and 89.2%, for the third year these were found to be 84.9 and 82.1%. Mean creatinine levels of both groups were compared in the first and third years. The results for groups 1 and 2 were 1.41 +/- 0.37 and 1.46 +/- 0.46 mg/dl respectively for the first year. In the third year these were found to be 1.60 +/- 0.43 and 1.69 +/- 0.49 mg/dl and there was no statistically significant difference between the groups. Vascular and urological complications were observed in only 6 out of 187 cases (3.2%).

No significant difference has been observed between single and MRA kidneys considering the success and complication rates of renal allotransplantation.