Does Renal Artery Multiplicity Have Impact on Patient and Allograft Survival Rates?

Background and Aims: Successful transplantation of allografts with multiple renal arteries (MRAs) is one of the challenges and requires investigation of its impact on post-transplant graft and patient outcome. The aim of this study was to determine the impact of kidneys with MRAs on graft and patient survival rates.

Methods: We retrospectively reviewed the medical records of 90 grafts with MRAs that were performed between June 1995 and June 2008. Recipients were divided into 3 groups: group I (n =230) single renal artery, group II (n =83) with double renal arteries and group III (n =7) with triple renal arteries. The aspects analyzed were number of kidney's arteries, donor type, vascular reconstruction technique, surgical complications, as well as patient and graft survival.

Results: No significant differences were noted in the sex of the recipients, donor source, body mass index (BMI) at the time of transplantation, causes of ESRD, occurrence of complications, vascular reconstruction technique, warm ischemic times, number of transplantation and immunosuppression regimen. The mean cold ischemic time in MRAs group was significantly higher than the control group (P<0.05). One year patient survival rates were 97%, 97% and 71% in groups I, II and III, respectively (I vs. II, P=0.7, HR=1.26; I vs. III, P=0.004, HR=0.09 and II vs. III, P=0.01, HR=0.07). The graft survival rates at one year were 95% in group I; 95% in group II; and 71% in group III (I vs. II, P= 0.4, HR=0.69; I vs. III, P=0.001, HR=0.11 and II vs. III, P=0.007, HR=0.15).

Conclusions: These findings indicate that kidney transplantation using grafts with MRAs are safe and result in acceptable patient and allograft outcome.