Sequential analysis of single-center experience of living donor kidney transplants with several vascular anastomosis techniques

BACKGROUND AND AIM: Vascular variations of grafts are handled with various reconstruction techniques in renal transplantation. We aimed to analyze the effects of these reconstruction techniques and sites on patient/graft outcomes. MATERIALS AND METHODS: Renal transplantation cases at the Transplantation Unit of the General Surgery Department, İstanbul University Cerrahpaşa Medical Faculty between January 1st, 2000 and December 31st, 2012 were analyzed retrospectively. Postoperative duplex ultrasound results, urea-creatinine reduction rates, and complications were evaluated. RESULTS: There were 228 living-donor transplantation cases evaluated. For single-renal-artery living-donor transplantations, there were 45 end-to-side external iliac artery, 15 end-to-side internal iliac artery, 152 end-to-end internal iliac artery, and 3 end-to-side common iliac artery anastomoses performed. In cases with double-arteries, 3 had end-to-side external iliac artery anastomoses, and 10 had endto-end internal iliac artery anastomoses. No statistically significant differences were found between reconstruction techniques with regard to complications or urea-creatinine reduction rates. CONCLUSION: Internal, external, and common iliac arteries can be safely used for anastomoses. The presence of more than one renal artery creates no short or long-term problems when a side-to-side anastomosis is initially performed.