The outcome of kidney transplants with multiple renal arteries

We reviewed the records of 225 adult kidney transplants done consecutively at our institution. Twenty-nine patients (12.8%) had grafts with multiple renal arteries. We analyzed the incidence of post-transplant hypertension and vascular complications, mean creatinine levels, patient and graft survival. In 17 cases reconstruction was done as conjoined anastomosis between two arteries of equal size, and in 6 cases as end-to-side anastomosis of smaller arteries to larger arteries. Multiple anastomoses were performed in 6 cases.In one patient postoperative bleeding occurred. Mean systolic blood pressures, creatinine levels at first year and last follow-up and complication rates were all in acceptable ranges. There was no significant difference in graft and patient survival between multiple and single renal artery allografts.Although the kidney grafts with multiple renal arteries have been considered a relative contraindication because of the increased risk of complications, in our study allografts with multiple arteries were used successfully in kidney transplantation.Although graft and patient survival have significantly improved because of standardization in surgical technique and immunosupressive therapy, grafts with anatomic variants are still challenging problems to the surgeon. Of these variants, multiple renal arteries are the most common. The use of these grafts has been considered a relative contraindication because of the increased incidence of vascular and urologic complications [1]. In this retrospective study, we reviewed the outcome of kidney transplantation using allografts with multiple renal arteries.We reviewed the records of 225 adult kidney transplants done consecutively at our institution. Twenty-nine patients (12.8%) had grafts with multiple renal arteries. The surgical management of multiple arteries was variable. In 17 cases reconstruction was done as conjoined anastomosis with two arteries of equal size, and in 6 cases as end-to-side anastomosis