MULTIPLE VERSUS SINGLE RENAL ARTERIES IMPACT ON GRAFT FUNCTION IN RENAL TRANSPLANTATION
Background: The incidence of end-stage renal disease is increasing worldwide. Kidney transplantation is the most effective single procedure for such patients. The presence of multiple renal arteries is grouped among one of the anatomical difficulties that are faced during renal transplantation.
Patients and methods: Patients who underwent renal transplantation over a period of 4 years were included in this study. The aim of this study was to analyze the incidence of complications among recipients of renal transplantation with a single renal artery and multiple arteries. The anatomy of the renal vasculature was determined by magnetic resonance arteriography.
Results: The study included 199 patients, 158 with multiple renal arteries, and 41 patients with single renal artery. There was no significant difference in donor age and the cause of renal failure between both groups (P values were 0.841 and 0.343), respectively. Idiopathic renal failure and diabetes mellitus were among the commonest caused of renal failure. There was a significant difference in the cold ischemia time between both study groups (P= <0.001), being higher in renal transplant recipients of kidneys with multiple renal arteries. In contrast, the hot ischemia time showed no significant difference. There was a very significant correlation regarding the development of complications between both groups (P=0.001). Urinary and vascular complications were commoner in patients with multiple renal arteries. The rate of vascular complications was higher in renal transplant recipients of kidneys with multiple renal arteries with no statistical significance between both study groups (P=0.197), while the urinary showed a very high significant correlation (P=0.001). Lymphatic leakage was more prevalent in those with a single renal artery (P=0.001). There was no difference regarding the graft rejection between both study groups. Two patients died, one from myocardial infarction and acute liver failure.
Conclusion: Renal transplantation for multiple renal arteries is safe and had no negative impact on the graft outcome with higher vascular complication rates.
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