Long-term graft outcome after renal arterial reconstruction during living related kidney transplantation.
OBJECTIVE
The aim of this retrospective study was to evaluate the repair of vascular variations/pathologies in living donor kidney transplantations in a single centre over a 15-year period.


METHODS
Between 01/1997 and 05/2012, 338 living donor renal transplantations were performed in the Department for Endovascular and Vascular Surgery, University of Düsseldorf, Germany. Twenty-four of them showed disorders, like multiple renal arteries (MRA), atherosclerotic stenosis or fibromuscular dysplasia (FMD) needing vascular repair before transplantation.


RESULTS
Mean age of donors was 51 ± 11.2, in recipient's 44 ± 13.9 years. In seven transplantations, renal artery (RA) repair was performed because of MRA. Atherosclerotic stenosis of the RA was apparent in 12 cases needing a repair with disobliteration. FMD was the reason in five transplantations for vascular repair. Complications like renal vessel thrombosis, lymphocele, heamorrhage, distal urinary leakage and ureteral obstruction was not significantly associated with RA reconstruction. Comparison of renal function in kidneys with reconstructed RA compared with kidneys without vascular repair showed no significant difference in primary function and serum creatinine up to the first year after transplantation. Mean follow-up was 75.6 ± 48.1 months. The 5-year graft survival rate for kidneys with RA repair was 88.5 vs. 93.4 % without reconstruction.


CONCLUSIONS
We could show that RA pathologies, suitable repaired, are not a contraindication for transplantation with acceptable 5-year-graft-survival rates.
Department of Vascular and Endovascular Surgery, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany, drsagban@yahoo.de.
Tolga Atilla
TA
Sagban
Barbara
B
Baur
Lars Christian
LC
Rump
Hubert
H
Schelzig
Klaus
K
Grabitz
Kai Michael
KM
Balzer
D000328:Adult; D005260:Female; D005352:Fibromuscular Dysplasia / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012077:Renal Artery / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*