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Category: Volume 06 Issue 01 January 2018
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Title: Outcome of Live Related Kidney Transplants with Multiple Renal Arteries

Authors: Jan Mohammad Rather, Mohammad Saleem Wani, Imtiyaz Ahmad Wani, Arif Hamid, Ab. Rouf Khawaja, Sobia Manzoor

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.55

Abstract

Introduction: The use of grafts with multiple renal arteries has been considered a relative contraindication because of the increased incidence of vascular and urological complications. The aim of the study is to determine whether the kidney grafts with multiple arteries have an adverse effect on the post transplant graft function and survival.

Methods:  A total of 107 kidney transplants done in our centre till december 2015 were reviewed. These were divided in two groups; group A- kidney grafts with single renal artery. Group B- kidney grafts with multiple renal arteries. Eighty nine grafts had single renal artery and eighteen had grafts with multiple renal arteries and hence required multiple vascular anastomoses. Anastomoses time, average blood loss, warm ischemia time(WIT), cold ischemia time(CIT), serum creatinine at 3,6 and 12 months, delayed graft function(DGF), renal artery stenosis (RAS), urological complications, graft survival at one year were studied in each group.

Results: No significant differences were seen in the two groups regarding serum creatinine (p value of 0.224, 0.248, 0.458 at 3, 6 and 12 months respectively), DGF (7:2, p value 0.645), RAS (2:1, p value of 0.428), urological complications (10:3, p value of 0.645). Significant differences are seen in anastomoses time (29.83: 44.72 mints, p value <0.001), WIT (17.1 : 18.4 sec, p value of <0.001), CIT (50.9: 77.5 min, p value <0.001), blood loss (157:219 ml, p value of <0.001) and lymphocele formation (4:4, p value of 0.026). However this did not seem to have any effect in the graft survival at one year. The difference in graft survival between the two groups was insignificant (8:2, p value of 0.674)

Conclusions: kidney transplantation using grafts with multiple renal arteries may be associated with higher rates of lymphocele formation along with increased blood loss, CIT, WIT and anastomoses time. However it is equally safe as using grafts with single renal artery regarding vascular, urological complications as well as the graft survival.

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Corresponding Author

Jan Mohammad Rather

Dept of General Surgery, Sher-E-Kashmir Institute of Medical Sciences

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