title: Preservation of deep inferior epigastric artery at kidney transplantation prevents atrophy of lower rectus abdominis muscle.
abstract: BACKGROUND
  The deep inferior epigastric artery (DIEA), which feeds the lower rectus abdominis muscle (lower RAM), is usually transected in kidney transplantation. In this study, we investigated whether preservation of DIEA can prevent lower RAM atrophy.
  
  
  METHODS
  Two hundred and forty-five kidney transplant recipients (150 men and 95 women) were enrolled in the study (mean age 39.9 years) and were divided into two groups according to whether DIEA was transected (group A, n = 175) or preserved (group B, n = 70). The extent of lower RAM atrophy calculated in computed tomography (performed 1 year after transplantation) and incidence of lower RAM atrophy were compared between the two groups. The most predictive factors for lower RAM atrophy were assessed using a multivariate logistic regression model.
  
  
  RESULTS
  The extent of lower RAM atrophy was significantly lower in group B (15.0 ± 18.5%) than that in group A (38.9 ± 25.4%, P = 0.003). The incidence of lower RAM atrophy was less prevalent in group B (20.0%) compared with that in group A (62.9%, P < 0.001). The sacrifice of DIEA was the only independent predictive factor for lower RAM atrophy (P < 0.001).
  
  
  CONCLUSIONS
  Preservation of DIEA during kidney transplant can prevent lower RAM atrophy.
authors.affiliation: Department of Urology, Hokkaido University Hospital, Sapporo, Japan. iwamidaiki@ybb.ne.jp
authors.forename: Daiki
authors.initials: D
authors.lastname: Iwami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Harada
authors.forename: Ken
authors.initials: K
authors.lastname: Morita
authors.forename: Koji
authors.initials: K
authors.lastname: Oba
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Fukuzawa
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Hotta
authors.forename: Hajime
authors.initials: H
authors.lastname: Sasaki
authors.forename: Chihoko
authors.initials: C
authors.lastname: Miyazaki
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nonomura
mesh_terms: D000328:Adult; D001284:Atrophy; D015331:Cohort Studies; D019074:Epigastric Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017568:Rectus Abdominis / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed