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Evaluating Graft Loss Risk in Living-Donor Kidney Transplants with Multiple Renal Arteries

Kuniaki Inoue1, Shunta Hori1, Mitsuru Tomizawa1

  • 1Department of Urology, Nara Medical University, Kashihara, Nara, Japan.

Annals of Transplantation
|January 13, 2025
PubMed

Insights

Kidney transplantation with multiple renal arteries (MRA) shows comparable outcomes to single renal artery transplants. However, MRA increases graft loss risk in ABO blood-incompatible kidney transplants.

Area of Science:

  • Nephrology
  • Transplant Surgery
  • Immunology

Background:

  • Kidney transplantation (KT) with multiple renal arteries (MRA) presents surgical complexity but comparable outcomes to single renal artery (SRA) transplants.
  • Understanding MRA's impact on graft survival and identifying associated risks is crucial for optimizing KT outcomes.

Purpose of the Study:

  • To evaluate the effect of multiple renal arteries (MRA) on kidney transplant prognosis.
  • To identify risk factors for graft loss specifically in living-donor KT recipients with MRA.

Main Methods:

  • Retrospective analysis of 197 living-donor KT recipients from February 2002 to March 2023.
  • Utilized inverse probability of treatment weighting to compare graft loss between MRA and SRA groups.
  • Investigated recipient characteristics as potential risk factors for graft loss in MRA cases.

Main Results:

  • Out of 197 recipients, 47 (23.8%) received kidneys with MRA.
  • No significant increase in graft loss risk was observed for MRA compared to SRA transplants (HR: 1.46; 95% CI: 0.68-3.14).
  • Multiple renal arteries (MRA) were significantly associated with increased graft loss in ABO blood-incompatible KT (HR: 5.09, 95% CI: 1.75-14.7).

Conclusions:

  • Multiple renal arteries (MRA) do not inherently worsen kidney transplant prognosis in general.
  • ABO blood-incompatible kidney transplantation with MRA poses a significantly higher risk of graft loss.
  • Careful consideration and management strategies are warranted for MRA in ABO incompatible KT.

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