Does kidney transplantation with multiple arteries affect graft survival?

Area of Science:

• Nephrology
• Transplant Surgery
• Vascular Surgery

Background:

• Renal transplantation is a critical treatment for end-stage renal disease.
• Graft selection often involves evaluating the number of renal arteries.
• Understanding outcomes for single versus multiple renal artery grafts is crucial for surgical planning.

Purpose of the Study:

• To compare short- and long-term outcomes of renal transplants utilizing single versus multiple renal arteries.
• To assess differences in vascular and urological complications between the two groups.
• To evaluate the impact on patient and graft survival rates.

Main Methods:

• Retrospective analysis of 208 living donor kidney transplants (1994-2010).
• Grafts categorized into single (n=164) and multiple (n=44) renal artery groups.
• Comparison of early/late complications, patient/graft survival using Kaplan-Meier curves and log-rank tests.

Main Results:

• No significant differences in acute rejection, hypertension, or renal artery stenosis.
• Hemorrhagic complications and renal artery thrombosis were higher in the multiple renal artery group (P=.027, P=.03).
• Similar graft function and return to hemodialysis rates between groups; longer warm ischemia time in multiple artery group did not affect acute tubular necrosis.

Conclusions:

• Allografts with multiple renal arteries are safe and successful in kidney transplantation.
• Surgical outcomes are not negatively impacted by multiple arteries when performed by experienced teams.
• Patient and graft survival rates are comparable between single and multiple renal artery grafts.