title: Outcome of Living Donor Transplant Kidneys With Multiple Arteries.
abstract: BACKGROUND
  Living donor transplantation (LDT) using kidneys with multiple arteries (MA) has previously been reported to be associated with increased complications and poorer outcomes in recipients. The objective of this study was to investigate outcomes of LDT with MA at the National University Hospital of Singapore, an institution with modest kidney transplant volumes.
  
  
  METHODS
  From 2007 to 2014, a total of 109 consecutive living donor kidney transplantations were performed. Of the nephrectomies, 91% were left sided. A total of 19 cases involved MA, of which 7 with small polar vessels (<2 mm) were ligated and 12 were revascularized. Baseline characteristics and outcomes were comparable between donor-recipient pairs with MA and single artery (SA). Both groups had equivalent induction and maintenance immunosuppressive regimens.
  
  
  RESULTS
  Mean warm ischemia time (minutes) was similar for kidneys with MA and SA (4.3 ± 3.2 vs 3.9 ± 3.2, P = .38). Operative time (minutes) in the recipients was also equivalent (P > .05) for MA and SA (158 ± 39.2 and 145 ± 57.2, respectively). The MA kidney recipients had a lower estimated glomerular filtration rate (eGFR) on postoperative day 5 compared to SA (56.6 ± 24.2 vs 74.1 ± 35.9 mL/min/1.73 m(2), P = .058). However, eGFR at 1 year was the similar for both groups (64.9 ± 16.2 vs 66.4 ± 18.1 mL/min/1.73 m(2), respectively, P = .76). Delayed graft function rates were 5.6% and 6.6% for MA and SA, respectively (P = .9). There were no surgical complications for LDT recipients within the MA group. Patient and graft survival was 100% in the MA group compared with 98% in the SA group (P > .05).
  
  
  CONCLUSIONS
  With current surgical techniques, LDT with MA can achieve equally good functional outcomes at 1 year as SA kidneys, with minimal surgical complications.
authors.affiliation: Department of Urology, National University Health System, Singapore.
authors.forename: Y M J
authors.initials: YM
authors.lastname: Lim
authors.affiliation: Department of Urology, National University Health System, Singapore.
authors.forename: X
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of Urology, National University Health System, Singapore.
authors.forename: L
authors.initials: L
authors.lastname: Raman
authors.affiliation: Department of Urology, National University Health System, Singapore.
authors.forename: T K
authors.initials: TK
authors.lastname: Ng
authors.affiliation: Department of Urology, National University Health System, Singapore.
authors.forename: T H A
authors.initials: TH
authors.lastname: Goh
authors.affiliation: Department of Urology, National University Health System, Singapore.
authors.forename: A
authors.initials: A
authors.lastname: Vathsala
authors.affiliation: Department of Urology, National University Health System, Singapore. Electronic address: cfsthy@nus.edu.sg.
authors.forename: H Y
authors.initials: HY
authors.lastname: Tiong
mesh_terms: D000328:Adult; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012077:Renal Artery / Q000637:transplantation*; D012189:Retrospective Studies