Comparison between single and multiple renal vessels in live donor allograft kidney transplantation: Surgical aspects and outcomes, 25 years experience

Abstract

Background: The evolving increase in incidence of end stage renal disease in Iraq leading to higher need for live donor kidney transplant that is facing big challenge of live donation shortage which acquire re-evaluation for live donation exclusion criteria. Aim of study: To assess whether kidney transplantation using grafts with multiple vessels is associated with higher rate of complications than single vessel. Patients & methods: A retrospective cross sectional review study carried at Renal Transplant Center-Medical City teaching hospital and Private Hospitals in Baghdad-Iraq, during the period from 1st of June 1997 to 1st of June 2017 on convenient sample of 2674 live donor transplant patients. The patients were classified first into two groups (single renal vessel vs. multiple renal vessels) and second into four groups: Group A: 1837 grafts with a single artery single anastomosis. Group B: 483 grafts with multiple arteries single anastomosis, Group C-1,2,3: 202 grafts with multiple arteries multiple anastomosis, Group D: 152 grafts with multiple veins multiple anastomosis. Results: The vascular reconstruction of renal artery for transplant patients was either single renal vessel (68.7%) or multiple renal vessels (31.3%). No significant differences were observed between transplant patients with single renal vessel and patients with multiple renal vessels regarding survival duration, outcome, graft survival and graft survival duration. There was a highly significant association between younger age transplant patients and single renal vessel graft (p < 0.001). Conclusions: The long term outcomes of patients transplanted with single vessel live donor allograft kidney and patients transplanted with multiple vessels live donor allograft kidney are not obviously different. Highlights