Management and outcome of living kidney grafts with multiple arteries.
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.
Kadotani
Yayoi
Y
Department of Transplantation and Regenerative Surgery, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan.
Okamoto
Masahiko
M
Akioka
Kiyokazu
K
Ushigome
Hidetaka
H
Ogino
Shiro
S
Nobori
Shuji
S
Higuchi
Atsushi
A
Wakabayashi
Yoshihiro
Y
Kaihara
Satoshi
S
Yoshimura
Norio
N
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
D003404:Creatinine