INITIAL EXPERIENCES WITH THREE RENAL ARTERIES OF KIDNEY ALLOGRAFT IN KIDNEY TRANSPLANTATION: A CASE SERIES

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Published 2016-09-07
Tommie Prasetyo Nur Rasyid Arry Rodjani

Abstract

Objective: This study reported a case series of our initial experiences in kidney transplantation with three renal arteries of the kidney allograft. Material & methods: The kidney allograft from all of the four cases was harvested with laparoscopic living donor nephrectomy. End-to-side anastomosis was performed from the small artery to the larger main artery before side-to-side anastomosis was performed between the two arteries of equal size. After joining the renal arteries we performed end-to-side anastomosis from the renal vein and artery to the external iliac vein and artery respectively. Results: All of the four cases respond well to the allograft kidney. Three recipients had normal serum creatinine level before 5 days after transplantation. One recipient had undergone hemodialysis once on the third day after transplantation. All of the recipients have no vascular and urologic complications. Conclusion: Multiple renal arteries are no longer considered as a relative contraindication, especially with meticulous anastomosis technique. No vascular and urologic complication was observed from this technique.


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Keywords

renal arteries, transplant, allograft, kidney

References

Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011 Oct; 11(10): 2093-109.

Chabchoub K, Mhiri MN, Bahloul A, Fakhfakh S, Ben Hmida I, HadjSlimen M, et al. Does kidney transplantation with multiple arteries affect graft survival? Transplant Proc. 2011 Nov; 43(9): 3423-5.

Murray JE, Merrill JP, Harrison JH. Kidney transplantation between seven pairs of identical twins. Ann Surg. 1958; 148(3): 343-59.

Reimer J, Franke GH, Lutkes P, Kohnle M, Gerken G, Philipp T, et al. Quality of life in patients before and after kidney transplantation. PsychotherPsychosom Med Psychol. 2002; 52(1): 16-23.

Beckmann JH, Jackobs S, Klempnauer J. Arterial reconstruction in kidney transplantation. Transplantations medizin. 2008; 20: 7-12.

Chabchoub K, Mhiri MN, Bahloul A, Fakhfakh S, Ben Hmida I, HadjSlimen M, et al. Does kidney transplantation with multiple arteries affect graft survival? Transplant Proc. 2011 Nov; 43(9): 3423-5.

Benedetti E, Troppmann C, Gillingham K, Sutherland DE, Payne WD, Dunn DL, et al. Short- and long-term outcomes of kidney transplants with multiple renal arteries. Ann Surg. 1995 Apr; 221(4): 406-14.

Alarcón CM, Pastor GS, González PAL, Cubillana PL, Morcillo JCR, Iñíguez GD, et al. Must we still be worried about multiple arteries in kidney transplantation? Nephro-Urol Mon. 2012; 5(1): 692-6.

Makiyama K, Tanabe K, Ishida H, Tokumoto T, Shimmura H, Omoto K, et al. Successful renovascular reconstruction for renal allografts with multiple renal arteries. Transplantation. 2003; 75(6): 828-32.

Ali-El-Dein B, Osman Y, Shokeir AA, El-dein ABS, Sheashaa H, Ghoneim MA. Multiple arteries in live donor renal transplantation: Surgical aspects and outcomes. J Urol. 2003 Jun; 169(6): 2013-7.

Saidi R, Kawai T, Kennealey P, Tsouflas G, Elias N, Hertl M, et al. Living donor kidney transplantation with multiple arteries: recent increase in modern era of laparoscopic donor nephrectomy. Arch Surg. 2009 May; 144(5): 472-5.

Başaran O, Moray G, Emiroğlu R, Alevli F, Haberal M. Graft and patient outcomes among recipients of renal grafts with multiple arteries. Transplant Proc. 2004 Jan-Feb; 36(1): 102-4.

Bakirtas H, Guvence N, Eroglu M, Ure M, Ozok HU, Karabulut I, et al. Surgical approach to cases with multiple renal arteries in renal transplantation. Urol Int. 2006; 76(2): 169-72.

Oh HK, Hawasli A, Cousins G. Management of renal allografts with multiple renal arteries resulting from laparoscopic living donor nephrectomy. Clin Transplant. 2003 Aug; 17(4): 353-7.

Chedid MF, Muthu C, Nyberg SL, Lesnick TG, Kremers WK, Prieto M, et al. Living donor kidney transplantation using laparoscopically procured multiple renal artery kidneys and right kidneys. J Am Coll Surg. 2013 Jul; 217(1): 144-52.

Gawish AE, Donia F, Samhan M, Halim MA, Al-Mousawi M. Outcome of renal allografts with multiple arteries. Transplant Proc. 2007 May; 39(4): 1116-7.

Hung CJ, Lin YJ, Chang SS, Chou TC, Lee PC. Kidney grafts with multiple renal arteries is no longer a relative contraindication with advance in surgical techniques of laparoscopic donor nephrectomy. Transplant Proc. 2012 Jan; 44(1): 36-8.

Ghazanfar A, Tavakoli A, Zaki MR, Pararajasingam R, Campbell T, Parrott NR, et al. The outcomes of living donor renal transplants with multiple renal arteries: a large cohort study with a mean follow-up period of 10 years. Transplant Proc. 2010 Jun; 42(5): 1654-8.

Mazzucchi E, Souza AA, Nahas WC, Antonopuolos IM, Piovesan AC, Arap S. Surgical complications after renal transplantation in grafts with multiple arteries. Int Braz J Urol. 2005; 31(2): 125-30.

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Department of Urology, Faculty of Medicine/Airlangga University