Cargando…
Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation
Aim: Complex arterial reconstruction in kidney transplantation (KT) using kidneys from deceased donors (DD) warrants additional study since little is known about the effects on the mid- and long-term outcome and graft survival. Methods: A total of 451 patients receiving deceased donor KT in our depa...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509629/ https://www.ncbi.nlm.nih.gov/pubmed/34640413 http://dx.doi.org/10.3390/jcm10194395 |
_version_ | 1784582389276606464 |
---|---|
author | Scheuermann, Uwe Rademacher, Sebastian Wagner, Tristan Lederer, Andri Hau, Hans-Michael Seehofer, Daniel Sucher, Robert |
author_facet | Scheuermann, Uwe Rademacher, Sebastian Wagner, Tristan Lederer, Andri Hau, Hans-Michael Seehofer, Daniel Sucher, Robert |
author_sort | Scheuermann, Uwe |
collection | PubMed |
description | Aim: Complex arterial reconstruction in kidney transplantation (KT) using kidneys from deceased donors (DD) warrants additional study since little is known about the effects on the mid- and long-term outcome and graft survival. Methods: A total of 451 patients receiving deceased donor KT in our department between 1993 and 2017 were included in our study. Patients were divided into three groups according to the number of arteries and anastomosis: (A) 1 renal artery, 1 arterial anastomosis (N = 369); (B) >1 renal artery, 1 arterial anastomosis (N = 47); and (C) >1 renal artery, >1 arterial anastomosis (N = 35). Furthermore, the influence of localization of the arterial anastomosis (common iliac artery (CIA), versus non-CIA) was analyzed. Clinicopathological characteristics, outcome, and graft and patient survival of all groups were compared retrospectively. Results: With growing vascular complexity, the time of warm ischemia increased significantly (groups A, B, and C: 40 ± 19 min, 45 ± 19 min, and 50 ± 17 min, respectively; p = 0.006). Furthermore, the duration of operation was prolonged, although this did not reach significance (groups A, B, and C: 175 ± 98 min, 180 ± 35 min, and 210 ± 43 min, respectively; p = 0.352). There were no significant differences regarding surgical complications, post-transplant kidney function (delayed graft function, initial non-function, episodes of acute rejection), or long-term graft survival. Regarding the localization of the arterial anastomosis, non-CIA was an independent prognostic factor for deep vein thrombosis in multivariate analysis (CIA versus non-CIA: OR 11.551; 95% CI, 1.218–109.554; p = 0.033). Conclusion: Multiple-donor renal arteries should not be considered a contraindication to deceased KT, as morbidity rates and long-term outcomes seem to be comparable with grafts with single arteries and less complex anastomoses. |
format | Online Article Text |
id | pubmed-8509629 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85096292021-10-13 Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation Scheuermann, Uwe Rademacher, Sebastian Wagner, Tristan Lederer, Andri Hau, Hans-Michael Seehofer, Daniel Sucher, Robert J Clin Med Article Aim: Complex arterial reconstruction in kidney transplantation (KT) using kidneys from deceased donors (DD) warrants additional study since little is known about the effects on the mid- and long-term outcome and graft survival. Methods: A total of 451 patients receiving deceased donor KT in our department between 1993 and 2017 were included in our study. Patients were divided into three groups according to the number of arteries and anastomosis: (A) 1 renal artery, 1 arterial anastomosis (N = 369); (B) >1 renal artery, 1 arterial anastomosis (N = 47); and (C) >1 renal artery, >1 arterial anastomosis (N = 35). Furthermore, the influence of localization of the arterial anastomosis (common iliac artery (CIA), versus non-CIA) was analyzed. Clinicopathological characteristics, outcome, and graft and patient survival of all groups were compared retrospectively. Results: With growing vascular complexity, the time of warm ischemia increased significantly (groups A, B, and C: 40 ± 19 min, 45 ± 19 min, and 50 ± 17 min, respectively; p = 0.006). Furthermore, the duration of operation was prolonged, although this did not reach significance (groups A, B, and C: 175 ± 98 min, 180 ± 35 min, and 210 ± 43 min, respectively; p = 0.352). There were no significant differences regarding surgical complications, post-transplant kidney function (delayed graft function, initial non-function, episodes of acute rejection), or long-term graft survival. Regarding the localization of the arterial anastomosis, non-CIA was an independent prognostic factor for deep vein thrombosis in multivariate analysis (CIA versus non-CIA: OR 11.551; 95% CI, 1.218–109.554; p = 0.033). Conclusion: Multiple-donor renal arteries should not be considered a contraindication to deceased KT, as morbidity rates and long-term outcomes seem to be comparable with grafts with single arteries and less complex anastomoses. MDPI 2021-09-26 /pmc/articles/PMC8509629/ /pubmed/34640413 http://dx.doi.org/10.3390/jcm10194395 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Scheuermann, Uwe Rademacher, Sebastian Wagner, Tristan Lederer, Andri Hau, Hans-Michael Seehofer, Daniel Sucher, Robert Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation |
title | Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation |
title_full | Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation |
title_fullStr | Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation |
title_full_unstemmed | Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation |
title_short | Influence of Multiple Donor Renal Arteries on the Outcome and Graft Survival in Deceased Donor Kidney Transplantation |
title_sort | influence of multiple donor renal arteries on the outcome and graft survival in deceased donor kidney transplantation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509629/ https://www.ncbi.nlm.nih.gov/pubmed/34640413 http://dx.doi.org/10.3390/jcm10194395 |
work_keys_str_mv | AT scheuermannuwe influenceofmultipledonorrenalarteriesontheoutcomeandgraftsurvivalindeceaseddonorkidneytransplantation AT rademachersebastian influenceofmultipledonorrenalarteriesontheoutcomeandgraftsurvivalindeceaseddonorkidneytransplantation AT wagnertristan influenceofmultipledonorrenalarteriesontheoutcomeandgraftsurvivalindeceaseddonorkidneytransplantation AT ledererandri influenceofmultipledonorrenalarteriesontheoutcomeandgraftsurvivalindeceaseddonorkidneytransplantation AT hauhansmichael influenceofmultipledonorrenalarteriesontheoutcomeandgraftsurvivalindeceaseddonorkidneytransplantation AT seehoferdaniel influenceofmultipledonorrenalarteriesontheoutcomeandgraftsurvivalindeceaseddonorkidneytransplantation AT sucherrobert influenceofmultipledonorrenalarteriesontheoutcomeandgraftsurvivalindeceaseddonorkidneytransplantation |