title: Management and outcome of living kidney grafts with multiple arteries.
abstract: OBJECTIVE
  Kidney allografts with multiple renal arteries (MRAs) have been used with increasing frequency since the advent of laparoscopic live donor nephrectomy. To determine if MRA grafts affect the short- and long-term outcomes of grafts and patients, we analyzed 340 grafts procured by open nephrectomy.
  
  
  METHODS
  We divided the graft recipients into five groups according to the methods used for vascular reconstruction. We compared patient and graft survival, serum creatinine levels, total (rewarm) ischemic times (TIT), incidence of acute tubular necrosis (ATN), need for antihypertensive drugs, incidence of acute rejection episodes, and vascular and urologic complications, between the MRA group and a control group of patients with single-artery renal grafts.
  
  
  RESULTS
  In patients who underwent multiple anastomoses in situ, prolonged TIT resulted in an increased incidence of ATN, but there was no significant difference between the MRA groups and the control group (P = 0.45). The incidence of vascular complications was higher in the MRA groups (P < 0.01), but there were no significant differences in the other variables among the groups.
  
  
  CONCLUSIONS
  Multiple renal artery grafts procured by open nephrectomy can be transplanted as successfully as those with single arteries, by using meticulous suturing techniques.
authors.affiliation: Department of Transplantation and Regenerative Surgery, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Kadotani
authors.forename: Masahiko
authors.initials: M
authors.lastname: Okamoto
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Akioka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ushigome
authors.forename: Shiro
authors.initials: S
authors.lastname: Ogino
authors.forename: Shuji
authors.initials: S
authors.lastname: Nobori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Higuchi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Wakabayashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kaihara
authors.forename: Norio
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D007673:Kidney Cortex Necrosis / Q000453:epidemiology; D016030:Kidney Transplantation / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: D003404:Creatinine