Korean J Transplant.  2022 Nov;36(Supple 1):S131. 10.4285/ATW2022.F-2515.

Effect of vascular reconstruction types on dual arteries in living donor kidney transplantation

• Chang WB
• Lee T
• Shin Y

• KMID: 2535647
• DOI: http://doi.org/10.4285/ATW2022.F-2515

Abstract

Background
The situation with donor's two renal arteries in kidney transplantation is challenging. Unlike the single artery, addi-tional anastomosis is required, and various reconstructions can be attempted depending on the arrangement of the two arteries. We tried to investigate the outcome according to the reconstruction methods of two arteries.
Methods
Among the 387 patients who underwent living donor kidney transplantation at Seoul National University Bundang Hospital from 2005 to 2021, 86 cases had double donor renal arteries. As for the reconstruction methods, internal and external iliac arteries was nine cases, inferior epigastric artery was 15 cases, anterior and posterior division of internal iliac artery was 23 cases, end to side was 20 cases, and side to side was nine cases. Then we compared these groups with the control group, single artery (n=292).
Results
As a short-term result, there was no difference in postoperative 40-days GFR (MDRD) according to reconstruction method (P=0.176). In 1-year survival analysis, graft survival in side to side group was significantly decreased (P=0.018), and patient survival was also decreased in side to side group (P=0.001). In case of 3-year graft survival, there was no significant difference between the groups (P=0.074), but a trend of decreasing survival rate was observed in side to side and inferior epi-gastric group on the survival curve. The 3-year patient survival was significantly decreased in side to side group (P=0.001). In 5-year long-term survival analysis, there was no significant difference in graft survival between groups (P=0.525), however survival rate of side to side and inferior epigastric groups tended to decrease in the survival curve. The 5-year patient survival was significantly decreased in side to side group (P=0.001).
Conclusions
Our study shows that side to side reconstruction method for two donor renal artery is disadvantageous in patient survival of 1, 3, 5 years and inferior in 1-year graft survival.