Introduction: The presence of multiple renal arteries (MRA) in the donor allograft\nwas once a contraindication to transplantation. Despite concerns about\nrisks, these allografts are being increasingly used to overcome a shortage of\nrenal donors. Objectives: To compare the outcomes of live-donor renal allografts\nwith multiple and single renal arteries (SRA) in terms of overall ischemia\ntimes, early and late graft function, and vascular and urological complications.\nMethods: A prospective, non-randomized cohort study was conducted\nincluding all live donor renal transplants done by the Vascular and Transplant\nUnit of the National Institute of Nephrology Dialysis and Transplantation, Sri\nLanka between March 2010 and March 2016. 312 recipients of live donor renal\nallografts were recruited to the study. Patients were divided into three\ngroups: Group 1ââ?¬â?SRA: single anastomosis (n = 264, 85%); Group 2ââ?¬â?MRA:\nsingle conjoined anastomosis (n = 39, 12%); and Group 3ââ?¬â?MRA: ââ?°Â¥2 anastomoses\n(n = 9, 3%). Results: Mean ischaemia times (donor clamping to graft\nreperfusion) in the three groups were 14, 21 and 17 minutes respectively.\nFailure to normalize creatinine within 72 hours was seen in 29/264 (11%),\n4/39 (10.2%) and 1/9 (11%), (P > 0.05). Delayed graft function (attributable\nto severe rejection) occurred in only one patient who was from group 2.\nOne-year graft survival among the groups was 243/264 (92%), 35/39 (90%)\nand 8/9 (89%), (P > 0.05). One patient from groups 1 and 2 developed\ntransplant renal artery stenosis. Two patients from group 1 needed stenting\nfor ureteric stenosis. Conclusions: Donor grafts with MRA may be accepted\nsafely with careful surgical reconstruction and close surveillance posttransplant.
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