title: Multiple arteries in live donor renal transplantation: surgical aspects and outcomes.
abstract: OBJECTIVE
  This retrospective study describes the surgical techniques and outcomes of live donor renal allografts with multiple arteries.
  
  
  METHODS
  Between 1976 and 2000, 1,200 consecutive live donor renal transplants were done, including 1,087 with single (group 1) and 113 with multiple (group 2) arteries. Intracorporeal in situ anastomotic techniques were used for 94 grafts with multiple arteries, while ex vivo techniques were used for 19. During in situ surgery each one of the multiple arteries was anastomosed separately to an individual artery. In ex vivo surgery 2 or more arteries were joined together on the bench to form a common stem, which was then anastomosed to an iliac artery or the aorta.
  
  
  RESULTS
  Patient and graft survival were comparable in groups 1 and 2. The 2 groups were comparable regarding complications, including arterial bleeding, hematoma, renal artery stenosis, acute rejection, new onset hypertension, acute tubular necrosis and urological complications. Mean serum creatinine +/- SD at 1 year was 1.4 +/- 0.5 and 1.5 +/- 0.6 mg./dl., and at 5 years it was 1.8 +/- 1 and 2.1 +/- 1.4 mg./dl. for the 2 groups, respectively. The difference was only significant at 1 year (p = 0.02). Graft and patient survival, and the incidence of the described complications were comparable for the ex vivo bench anastomotic techniques and intracorporeal in situ techniques in the group with multiple renal arteries.
  
  
  CONCLUSIONS
  The use of multiple arteries in renal allografts does not adversely affect patient or graft survival. It is not associated with an increased rate of complications except for significantly higher mean serum creatinine at 1 year. Extracorporeal bench surgery was as effective as intracorporeal surgery for the anastomosis of multiple renal arteries with no increase in the incidence of relevant complications.
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Bedeir
authors.initials: B
authors.lastname: Ali-El-Dein
authors.forename: Yasser
authors.initials: Y
authors.lastname: Osman
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Shokeir
authors.forename: Ahmed B
authors.initials: AB
authors.lastname: Shehab El-Dein
authors.forename: Hussein
authors.initials: H
authors.lastname: Sheashaa
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Ghoneim
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies