Study of the outcome of renal transplants with single versus multiple renal arteries in obese recipients

Abstract

As we all know, donor nephrectomy of multiple renal arteries (MRA) is not a contraindication, either by open or laparoscopic method. But the study of the effect on the recipients is still going on, and in obese patients, it is very less studied. Here we have made an attempt to study the outcome of single versus multiple renal arteries in obese patients. Graft survival and vascular and urological complications were studied and compared among the single versus multiple renal artery recipients and in obese and nonobese patients. Methods and materialRetrospectively, all the transplants done in the Department of Urology, CARE Hospital during the period of 2004–2015 were analyzed. All the patients underwent renal transplant as per hospital protocol. Statistical analysis usedData were analyzed using SPSS for Windows version 20 with relative risk calculated using stat pages software. Fisher's exact test and Kendall's tau-b were used to compare categorical data between the body mass index (BMI) and anatomical subgroups. ResultsOver all, 320 transplants were done; 224 were single renal artery (SRA) and 96 were multiple arteries. 286 had BMI <30 and 34 patients had BMI more than 30. Delayed graft function (DGF) was seen in 20 (6.25%), vascular complications in 10 (3.12%), urological complications in 15 (4.6%), wound infection in 20 (6.25%), and lymphocele in 16 (5%) was observed. Between single and multiple renal arteries, cold ischemia time, DGF, vascular complications, and one-year graft survival were suggestive of better results in SRA group. Compared to obese and nonobese single artery groups, nonobese group had better graft survival and lesser vascular complications. In multiple renal arteries also, obese patients with multiple vessel anastomosis had poor graft survival and increased vascular complications. ConclusionsEven though obesity is not a contraindication for renal transplant surgery, we need to be conscious while selecting patients with multiple renal arteries for obese recipients.