The outcomes of living donor renal transplants with multiple renal arteries: a large cohort study with a mean follow-up period of 10 years.
BACKGROUND
Living donor kidney transplants with multiple arteries are presumed to be associated with an increased risk of complications.


OBJECTIVE
The aim of the study was to compare the outcomes in living donor transplantation with the specific intention of comparing long-term outcomes in which the donor kidney had 1 or more renal arteries. The study was undertaken in 2 large transplant centers.


METHODS
A retrospective analysis of 201 living donor kidney transplants with multiple arteries that were performed between January 1985 and December 2004 was undertaken. We recorded patient and graft survivals, urological and vascular complications. Kaplan-Meier survival estimates were calculated, and 2-tailed Student t-test was used to compare outcomes. P < .05 was considered statistically significant.


RESULTS
Graft and patient survival at 1 year were 93% and 97% and at 5 years were 87% and 92%. The most common complications were vascular (8.9%), followed by urological (6%), acute tubular necrosis (5.5%), and posttransplant hypertension (4.0%). There was significantly higher incidence of acute tubular necrosis (ATN) in multiple-artery transplants.


CONCLUSIONS
In this large cohort of patients studied, apart from a higher incidence of ATN and vascular complications, it appears that the number of renal arteries did not have any adverse impact on the outcomes. The findings from this study suggest that live donor kidneys with multiple renal arteries can be safely utilized for renal transplantation.
Ghazanfar
A
A
Department of Transplant Surgery, Central Manchester University Hospitals NHS Foundation Trust Manchester Royal Infirmary, Manchester, England. ag_ali@yahoo.com
Tavakoli
A
A
Zaki
M R
MR
Pararajasingam
R
R
Campbell
T
T
Parrott
N R
NR
Augustine
T
T
Riad
H N
HN
D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D007683:Kidney Tubular Necrosis, Acute / Q000453:epidemiology; D019520:Living Donors / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012077:Renal Artery / Q000002:abnormalities / Q000033:anatomy & histology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000453:epidemiology / Q000209:etiology
D003404:Creatinine