Retroperitoneoscopic Procurement of Kidneys With Multiple Renal Arteries Does Not Affect Graft Survival and Ureteral Complications.

Abstract

Objective: To assess the effect of kidney allografts with multiple renal arteries (MRA) on donor and recipient outcomes after retroperitoneoscopic live donor nephrectomy (RPLDN). Patients and Methods: From July 2001 to August 2010, 533 patientsunderwent live donor kidney transplants with allografts procured by RPLDN at our center. Of these, 406, 105, and 22 patients had one, two, and three renal arteries, respectively. We compared retrospectively the collected clinical data of each donor with MRA and the recipient with those with single renal artery (SRA) as controls. Results: Significant differences were found between the one and three renal artery groups regarding operative time, estimated blood loss, warm and cold ischemic time, and incidence of slow graft function (SGF). There were no significant differences regarding patient and graft survival among the three groups. Major complications, such as open conversion, bleeding, and blood transfusion were not found in patients with MRA. Five ureteral complications occurred. Of these, one patient with MRA had ureteral complications. In univariate analysis, MRA patients had a risk factor of developing SGF (p = 0.005) but not ureteral complications following RPDN. Conclusions: Kidneys with MRAafter RPLDN increasethe risk of SGF in recipients. However, they provide similar outcomes regarding long-term graft survival and complications compared with those of SRA. Renal artery multiplicity may not increase the risk of ureteral complications.