Mehmet Erikoğlu, Bayram Çolak, Ahmet Tekin, Tevfik Küçükkartallar, Şakir Tavlı

Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Konya, Türkiye


Purpose: The most common anomaly seen in kidneys used for transplantation is numerical anomalies of the renal artery. The aim of our study is to discuss the artery anomalies we detected in renal transplantation cases in our clinic in line with the relevant literature.

Materials and Methods: Five (39%) of the patients were female, 8 were male (61%) and their mean age was 43.7 (22-73), mean follow- up period was 30.5 months (4 to 90). For 7 of the patients, the organs were transplanted from a cadaver and 6 were transplanted from living donors. 12 patients had double, 1 patient had three renal arteries. Six patients were given ex vivo pant type side by side reconstruction to obtain a single large artery and the external iliac was anastomosed to the artery. In 1 patient with a small inferior polar artery, the inferior polar artery was ligated. In 1 patient, the arteries were positioned by in situ anastomosis one by one. In one patient with three arteries, the upper arteries were positioned by pant type anastomosis and anastomosed as a single artery,and the lower polar artery was anastomosed with the inferior epigastric artery end to end.

Results: In four patients (30.7%) there was delayed graft function,1 patient (7.6%) developed acute rejection verified with biopsy. In the post-operative period, it was determined that 3 patients had lymphocele which did not require intervention, 1 patient had subcutaneous infection and 1 patient had perirenal hematoma. Subcutaneous infection recovered with antibiotic treatment. As for the patient with perirenal hematoma, the perirenal hematoma resorbed spontaneously.

Conclusion: Using kidneys with multiple renal arteries for transplantation brings with it some theoretical risks. Tubular necrosis, delayed graft function and rejection can be seen more frequently due to elongated cold or hot ischemia time. We are of the opinion that large and single renal artery anastomosis obtained with ex vivo pant anastomosis application can decrease the vascular complication risk in multiple renal artery.

Keywords: Renal transplantation, multiple renal arteries, renal anomaly