Comparison of Double Renal Artery Anastomosis With Single Renal Artery Anastomosis in Kidney Transplant Recipients; Is There Any Effect on Graft Function?

Objective: Vascular anatomical variations in the graft are evaluated regarding the number of arteries, early branching, and venous drainage. The aim of this study was to compare the outcomes of patients who underwent double renal artery anastomosis and single renal artery anastomosis in LDKT.

Methods: Between April 2019 and December 2023, LDKT cases were retrospectively evaluated in our center. A control group was formed from patients who underwent single renal artery anastomosis with similar characteristics to those who underwent double renal artery anastomosis. Demographic characteristics, graft function tests, routine blood and urine tests, postoperative artery resistivity index (ARI) and pulsatile index (PI) values, post-transplant complications, length of hospitalization, and control parameters at the last follow-up were evaluated.

Results: 174 living donor kidney transplants were performed during the defined period. The study group consisted of 20 patients (DRA group) who underwent double renal artery anastomosis, and the control group (SRA group) consisted of 33 patients who underwent single renal artery anastomosis. There was no significant difference between the demographic characteristics of the donors and recipients (P > .05). Postop and current ARI and PI values were also similar between the 2 groups (P > .05). However, the albumin/creatinine ratio in spot urine was significantly higher in DRA group compared to SRA group (P = .039).

Conclusion: Multiple vessel anastomoses are inevitably performed because of the variations seen in renal arteries. Even if the artery diameter is small, with good surgical technique, similar results can be achieved to anastomoses in single artery grafts.