Incidence of transplant renal artery stenosis (TRAS) and graft characteristics in renal transplant recipients with multiple renal arteries: A prospective observational study

Abstract

Background: This was a prospective observational study to evaluate the incidence of Transplant Renal Artery Stenosis (TRAS) and Graft characteristics in Renal Transplant Recipients with Multiple Renal Arteries. Material andMethods: In the present study 25 patients’ recipients of multiple renal artery graft kidney who underwent renal transplant after 30 the June 2016 till October 2017 with post-transplant serum creatinine ≤ 1.5mg/dl were included and evaluated for stenosis by CT Angiography done after period of 90 days. Results: In this study double renal artery was present in 96% patients and triple renal artery was present in 4% of patients. Only left laparoscopic donor nephrectomy was done in all the cases. Arterial reconstruction was done by three techniques – double barreling done in 48% of cases, Y graft in 20% of cases and end to side anastomosis to main renal artery in 32% cases. Reconstructed renal artery was anastomosed to recipient external iliac artery by end to side anastomosis in 24% of patients and recipient internal iliac artery by end to end anastomosis in 76% of cases. Loupe was used during surgery in 28% of cases. Atheroma was present in 4% of donor vessels and 4% of recipient vessels. There was no technical difficulty in positioning of kidney in any of cases. There was incidence of delayed graft functioning in 8% of cases. There was no evidence of TRAS in any of cases on CT Angiography. There was no evidence of contrast induced nephropathy in this study group. Conclusion: In conclusion, there was no evidence of TRAS was found in any case. Hence no association could be established between occurrence of TRAS and various factors in patients with multiple renal artery live donor transplants with reconstruction.