Relationship Between Arterioplasty and Renal Prognosis in Renal Transplantation: A Single-Center Retrospective Cohort...

Multi-artery kidney transplantation has historically been associated with a higher risk of complications and impaired graft function compared with single-artery transplantation. This study aimed to evaluate the relationship between arterioplasty and renal prognosis.

We conducted a retrospective cohort study of living-donor kidney transplants performed at our center between January 2015 and December 2022. Patients with multiple renal arteries, excluding those in which branches were ligated, were divided into an arterioplasty group (AP group) and a simple anastomosis group (SA group).

Among 201 living-donor kidney transplants, 46 and 140 patients were assigned to the AP and SA groups, respectively. At discharge, serum creatinine (s-Cr) levels were 1.62 ± 0.86 mg/dL and 1.41 ± 0.46 mg/dL (p = .35), and estimated glomerular filtration rates (eGFR) were 39.98 ± 17.19 and 43.67 ± 13.28 mL/min/1.73 m² (P = .05). At 1 year, s-Cr levels were 1.43 ± 0.56 mg/dL and 1.31 ± 0.40 mg/dL (P = .49), and eGFR values were 43.06 ± 15.45 and 45.87 ± 12.80 mL/min/1.73 m² (P = .24), with no significant differences. Intraoperative arterial re-anastomosis was performed in 3 (6.5%) and 8 patients (5.7%), respectively (P = 1.00). The 1-year graft survival rates were 97.8% and 97.1%, and patient survival rates were 100% and 99.3% in the AP and SA groups, respectively.

In living-donor kidney transplantation with multiple renal arteries, arterioplasty showed renal function and survival outcomes comparable to simple anastomosis, suggesting it may be a safe and useful approach.