Surgical Aspects and Outcomes of Kidney Transplantation with Multiple Renal Arteries

Aim: To evaluate the effect of multiple renal artery presence on the success and complication rate of renal transplantation. Patients and Methods: Between January, 1990 and June 2008, 1250 live donor kidney transplants were included in the study. Among the 1250 kidney transplants, there were 930 males and 320 females. We divided the study population in two groups according to their vascular reconstruction: Group A: 1130 grafts with a single artery. Group B: 120 grafts with multiple arteries. Intracorporeal in situ anatomotic techniques were used for 100 grafts with multiple arteries, while ex-vivo anastomotic techniques were used for 20 patients. We compared the incidence of post transpolant hypertension, acute tubular necrosis, acute rejection, vascular and urological complications, mean creatinine level at 1 and 5 years post transplant and patient and graft survival. Results: The patient and graft survival were comparable in group A and group B. The two groups were omparable regarding complication, including arterial bleeding, hematoma, renal artery stenosis, acute rejection, new onset hypertension, acute tubular necrosis and urological complications. Mean serum creatinine at 1 year was higher in group B than in group A (1.6 + 0.7 versus 1-3 + 0.5 mg/dl). However, this mean serum creatinine level was comparable in two groups at 5 years. Graft and patient survival and the incidence of the described complication were comparable for the ex vivo bench anastomotic techniques and intracorporeal in situ technique in group with multiple renal arteries. Conclusions: Although the kidney grafts with multiple renal arteries have been considered a relative contraindication because of increase risk of complications, allografts with multiple arteries were used successfully in kidney transplantation in our study. No significant difference has been observed between single and multiple renal arteries kidneys considering the success and complication rates of renal allotransplantation.