Ashraf Hafiz Shahzad, Hussain Imran, Siddiqui Amjad Ali, Ibrahim M Nasir, Khan Mohammadf Usman
Department of Kidney Transplant Surgery, National Institute of Kidney Diseases, Lahore, Pakistan.
Saudi J Kidney Dis Transpl. 2013 May;24(3):615-9. doi: 10.4103/1319-2442.111087.
The aim of our study was to compare the surgical complications and short-term outcome of renal transplants with single and multiple renal artery grafts. We reviewed the records of 105 kidney transplantations performed consecutively at our institution from July 2006 to May 2010. The data of 33 (31.4%) renal transplants with multiple arteries were compared with the 72 transplants with single artery (68.6%), and the incidence of surgical complications, post-transplant hypertension, acute tubular necrosis, acute graft rejection, mean creatinine level, and patient and graft survival was analyzed. We further subdivided the study recipients into three groups: group A (n = 72) with one-renal-artery allografts and one-artery anastomosis, group B (n = 6) with multiple-artery allografts with single-artery anastomosis, and group C (n = 27) with multiple-artery allografts with multiple arterial anasatomosis, and compared their outcome. No significant differences were observed among the recipients of all the three groups regarding early vascular and urological complications, post-transplant hypertension, acute tubular necrosis, acute rejection, creatinine level, and graft and patient survival. The mean cold ischemia time in groups B and C was significantly higher (P <0.05). One patient in group A developed renal vein thrombosis resulting in graft nephrectomy. None of the patients with multiple renal arteries developed either vascular or urological complications. In conclusion, kidney transplantation using grafts with multiple renal arteries is equally safe as using grafts with single renal artery, regarding vascular, urological complications, as well as patient and graft survival.
我们研究的目的是比较单支肾动脉移植物与多支肾动脉移植物肾移植的手术并发症及短期预后。我们回顾了2006年7月至2010年5月在我院连续进行的105例肾移植手术记录。将33例（31.4%）多支动脉肾移植的数据与72例单支动脉肾移植（68.6%）的数据进行比较，分析手术并发症、移植后高血压、急性肾小管坏死、急性移植物排斥反应、平均肌酐水平以及患者和移植物存活率。我们进一步将研究受者分为三组：A组（n = 72）为单支肾动脉同种异体移植且单动脉吻合；B组（n = 6）为多支动脉同种异体移植且单动脉吻合；C组（n = 27）为多支动脉同种异体移植且多动脉吻合，并比较它们的预后。在所有三组受者中，早期血管和泌尿系统并发症、移植后高血压、急性肾小管坏死、急性排斥反应、肌酐水平以及移植物和患者存活率方面均未观察到显著差异。B组和C组的平均冷缺血时间显著更高（P <0.05）。A组有1例患者发生肾静脉血栓形成，导致移植肾切除。多支肾动脉患者均未发生血管或泌尿系统并发症。总之，就血管、泌尿系统并发症以及患者和移植物存活率而言，使用多支肾动脉移植物进行肾移植与使用单支肾动脉移植物同样安全。
