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KMID : 0361120080220010070
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Korean Journal of Transplantation
2008 Volume.22 No. 1 p.70 ~ p.76
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Multiple Renal Artery Anastomosis in Kidney Transplantation: Clinical Outcome
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Doh Jae-Woon
Park Woo-Il
Choi Jae-Ho
Jeong Joon-Heon
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Abstract
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Purpose: Kidney transplantation with multiple renal arteries has been associated with higher incidence of vascular and urologic complications. Multiple renal arteries occur unilaterally and bilaterally in 23% and 10% of the population, respectively, so it would be clearly in the best interests to the recipients whether to include these individuals as organ donor candidates. There is an increasing requirement to use such kidneys and it is not unusual trend any more. Some authors insist the vessel anastomosis time (2nd warm ischemia time) exceeding 35 minutes may attribute to the development of acute tubular necrosis (ATN). There are various methods in anastomosis of multiple renal arteries but vascular and urologic complications depend on the technical surgical skills or methods of the vascular anastomosis.
Methods: A retrospective study was assessed for 454 kidney transplantations performed in the department of surgery, Maryknoll Medical Center between August, 1990, and May 2007. Study groups are divided into four groups according to anastomosis methods: Group I, a single-artery anastomosis (n=387) and others, multiple-artery anastomosis (Group II∼Group IV) includes extracorporeal (Group II), intracorporeal (Group III) artery anastomosis, and polar artery ligation (Group IV).
Results: Among those groups, there are no significant differences in 2nd warm ischemia time, serum creatinine level, recipient and graft survival rate, acute tubular necrosis, acute rejection rate, blood pressure change, and urologic and vascular complication.
Conclusion: Kidney transplantation of multiple renal arteries is not a difficult challenge any more and it is now more important to find out the better way and better result.
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KEYWORD
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Renal transplantation, Multiple renal arteries, Internal iliac artery interposition, 2nd warm ischemia time
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