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Outcomes of renal transplantations with multiple vessels
1Kartal Research and Education Hospital, Istanbul, Turkey.
Insights
Renal transplantation outcomes were similar for kidneys with multiple or single blood vessels. This study found no significant difference in complication rates or graft function between these groups.
Area of Science:
- Nephrology
- Transplant Surgery
- Vascular Surgery
Background:
- Renal transplantation is a life-saving procedure for end-stage renal disease.
- The presence of multiple renal arteries or veins can complicate surgical reconstruction.
- Understanding the impact of vascular variations on transplant outcomes is crucial.
Purpose of the Study:
- To compare the outcomes of renal transplantation in grafts with multiple versus single vascular structures.
- To evaluate the incidence of postoperative complications and graft function based on vascular anatomy.
Main Methods:
- A retrospective review of renal transplantations performed between 2004 and 2009.
- Patients were divided into two groups: multiple vessels (group 1) and single vessels (group 2).
- Graft function was assessed using scintigraphy and serum creatinine levels; complications were meticulously recorded.
Main Results:
- Graft survival and function, indicated by mean creatinine levels, were comparable between groups (1.21 ± 0.38 mg/dL vs. 1.12 ± 0.31 mg/dL, P = .215).
- The incidence of acute rejection was lower in the multiple-vessel group (1 vs. 7 cases).
- Delayed graft function occurred in one patient in group 1 versus 11 in group 2; overall complication rates were 21.79% (group 1) and 35.92% (group 2), though not statistically significant (P > .05).
Conclusions:
- Renal transplantation involving grafts with multiple vessels does not lead to a higher incidence of postoperative complications compared to single-vessel grafts.
- Vascular variations in renal grafts do not significantly impact early graft function or complication rates.
Aim:
We reviewed our renal transplantation experience with multiple renal arteries and veins.
Method:
We divided the patients who underwent renal transplantation between 2004 and 2009 into two groups according to the vascular structure: multiple (group 1) versus single (group 2). Vascular anastomoses were primarily completed in an end-to-side manner to the external iliac artery and vein. The number of involved vessels was 51 among the 23 patients in group 1. We evaluated the function of the transplanted kidney using scintigraphic studies and serum creatinine levels.
Results:
The male:female ratios were 15:8 and 73:30, mean ages 31.9 (range = 12-64) and 33.4 (range = 17-64) years, and the living related:cadaveric donor ratios 18:5 and 75:28 for groups 1 and 2, respectively. There was one case of acute rejection in group 1, and seven cases in group 2. The number of kidneys with delayed function was 11 in group 2 and one in group 1. Two perirenal abscesses, two urinary fistulae, one lymphocele, two hematomas around the kidney, and four renal artery stenoses were seen in group 2. The complication rates were 21.79% in group 1 and 35.92% in group 2. (χ(2) = 1.70, P > .05). The mean creatinine levels at 1 month after the transplantation were 1.21 ± 0.38 mg/dL and 1.12 ± 0.31 mg/dL in groups 1 and 2, respectively (P = .215).
Conclusion:
The incidences of postoperative complications were not different for renal grafts involving multiple versus single vessels.
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