Kidney transplantation from living donors with multiple renal arteries

Öz

Aim: Although better outcomes have been reported recently due to advances in surgical techniques, kidney artery variations are still important for good clinical results in transplantation. The aim of our study was to compare the clinical outcomes of grafts with one and two or more arteries.

Methods: Between April 2014 and January 2019, 117 patients with live kidney transplantations were evaluated retrospectively with two groups. Group 1 consisted with one artery grafts and Group 2: two or more arteries. We were evaluated clinical outcomes between groups. 

Results: Among 117 recipients, there were two or more arteries in 13 cases (11.1 %). There was no significant deference between these two groups in terms of clinical outcomes during a median 27 (1-60) months of follow-up (P=0.62).

Conclusion: It appears that the presence of renal grafts with two or more arteries may not be counted as a relative contraindication for renal transplantation.

Anahtar Kelimeler

• Kidney transplantation,Multiple arteries

Multiple renal arterlere sahip canlı donörlerden böbrek nakli

Öz

Amaç: Son zamanlarda cerrahi tekniklerdeki gelişmelere bağlı olarak böbrek naklinde daha iyi sonuçlar alınmasına rağmen, böbrek arter varyasyonları iyi klinik sonuçlar için halen önemlidir. Çalışmamızın amacı, bir ve iki veya daha fazla arterli greftlerin klinik sonuçlarını karşılaştırmaktı.

Yöntemler: Nisan 2014 ile Ocak 2019 arasında, canlı vericili böbrek nakli yapılan 117 hasta retrospektif olarak iki grupta değerlendirildi. Grup 1 bir arterli greft ve Grup 2 iki veya daha fazla arterli greftten oluşuyordu. Bu iki grup arasındaki klinik sonuçları değerlendirildi.

Bulgular: 117 alıcı arasında 13 (%11,1) olguda iki veya daha fazla arterli greft vardı. Ortalama 27 (1-60) aylık takip süresinde bu iki grup arasında klinik sonuçlar açısından anlamlı bir farklılık saptanmadı (P=0,62).

Sonuç: İki veya daha fazla arterli böbrek grefti kullanımının, böbrek nakli için göreceli bir kontrendikasyon olmadığı anlaşılmaktadır.

Anahtar Kelimeler

• Böbrek nakli,Multiple arter

Kaynakça

1. 1. Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, Klarenbach S, Gill J. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011 Oct;11(10):2093-109. doi: 10.1111/j.1600-6143.2011.03686.x.
2. 2. Satyapal KS, Haffejee AA, Singh B, Ramsaroop L, Robbs JV, Kalideen JM. Additional renal arteries incidence and morphometry. Surg Radiol Anat. 2001;23:33–8.
3. 3. Khamanarong K, Prachaney P, Utraravichien A, Tong-un T, Sripaoraya K. Anatomy of renal arterial supply. Clin Anat. 2004;17:334–6.
4. 4. Shoja MM, Tubbs RS, Shakeri A, et al. Peri-hilar branching patterns and morphologies of the renal artery: A review and anatomical study. Surg Radiol Anat. 2008;30:375–82.
5. 5. Al-Saeed O, Ismail M, Sheikh M, Al-Moosawi M, Al-Khawari H. Contrast-enhanced three-dimensional fastspoiled gradient magnetic resonance angiography of the renal arteries for potential living renal transplant donors: A comparative study with digital subtraction angiography. Australas Radiol. 2005;49:214–7.
6. 6. Vazquez R, Garcia L, Morales-Buenrostro L, et al. Renal grafts with multiple arteries: A relative contraindication for a renal transplant? Transplant Proc. 2010;42:2369–71.
7. 7. Bhatti AA, Chugtai A, Haslam P, Talbot D, Rix DA, Soomro NA. Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating the renal vascular anatomy in potential living renal donors. BJU Int. 2005;96:1105–8.
8. 8. Khanam A, Alam MR, Ahmed AH, Khan SA. The outcome of kidney transplants with multiple renal arteries. Mymensingh Med J. 2011;20:88-92.

9. 9. Makiyama K, Tanabe K, Ishida H, et al. Successful renovascular reconstruction for renal allografts with multiple renal arteries. Transplantation. 2003;75:828-32.
10. 10. Hung CJ, Lin YJ, Chang SS, Chou TC, Lee PC. Kidney grafts with multiple renal arteries is no longer a relative contraindication with advance in surgical techniques of laparoscopic donor nephrectomy. Transplant Proc. 2012;44:36-8.
11. 11. Breda A, Veale J, Liao J, Schulam PG.Complications of laparoscopic living donor nephrectomy and their management: the UCLA experience. Urology. 2007;69:49–52.
12. 12. Saidi R, Kawai T, Kennealey P, et al: Living donor kidney transplantation with multiple arteries: recent increase in modern era of laparoscopic donor nephrectomy. Arch Surg. 2009;144:472-5.
13. 13. Kadotani Y, Okamoto M, Akioka K, et al: Management and outcome of living kidney grafts with multiple arteries. Surg Today. 2005;35:459-66.
14. 14. Keller JE, Dolce CJ, Griffin D, et al. Maximizing the donor pool: use of right kidneys and kidneys with multiple arteries for live donor transplantation. Surg Endosc. 2009;23:2327-31.