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Open Access 01-12-2024 | Kidney Transplantation | Topic Paper

Retrospective analysis of the perioperative outcome in living donor kidney transplantation with multiple renal arteries: does accessory vessel ligation affect the outcome?

Authors: Jacob Schmidt, Robert Peters, Josef Mang, Bernhard Ralla, Diana Elena Moldovan, Julia Dagnæs-Hansen, Lutz Liefeldt, Klemens Budde, Markus Lerchbaumer, Frank Friedersdorff

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

Accurate surgical reconstruction of arterial vascular supply is a crucial part of living kidney transplantation (LDKT). The presence of multiple renal arteries (MRA) in grafts can be challenging. In the present study, we investigated the impact of ligation versus anastomosis of small accessory graft arteries on the perioperative outcome.

Methods

Clinical and radiological outcomes of 51 patients with MRA out of a total of 308 patients who underwent LDKT with MRA between 2011 and 2020 were stratified in two groups and analyzed. In group 1 (20 patients), ligation of accessory arteries (ARAs) and group 2 (31 patients) anastomosis of ARAs was performed.

Results

Significant differences were observed in the anastomosis-, surgery-, and warm ischemia time (WIT) in favor of group 1. Students t-test showed comparable serum creatinine levels of 2.33 (± 1.75) to 1.68 (± 0.83) mg/dL in group 1 and 2.63 (± 2.47) to 1.50 (± 0.41) mg/dL in group 2, were seen from 1 week to 1 year after transplant. No increased rates of Delayed graft function (DGF), primary transplant dysfunction and transplant rejection were seen, but graft loss and revision rates were slightly higher when the ARAs were ligated. Analysis of Doppler sonography revealed that segmental perfusion deficits tend to regenerate during the clinical course.

Conclusion

Ligation of smaller accessory renal arteries may not affect the outcome of living kidney transplantation, except for a minor increase in the reoperation rate. Segmental perfusion deficits of the graft seem to regenerate in most cases as seen in Doppler sonography.

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Title: Retrospective analysis of the perioperative outcome in living donor kidney transplantation with multiple renal arteries: does accessory vessel ligation affect the outcome?
Authors: Jacob Schmidt
Robert Peters
Josef Mang
Bernhard Ralla
Diana Elena Moldovan
Julia Dagnæs-Hansen
Lutz Liefeldt
Klemens Budde
Markus Lerchbaumer
Frank Friedersdorff
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04883-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Retrospective analysis of the perioperative outcome in living donor kidney transplantation with multiple renal arteries: does accessory vessel ligation affect the outcome?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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