Introduction: Because of the high incidence of urological and vascular complications, multiple renal artery (MRA) have been accepted to be a relative contraindication for kidney transplantation. By using appropriate vascular reconstruction and anastomosis techniques, transplantation of MRA is a safe procedure. We aimed to determine urological and vascular complications and to evaluate long-term graft survival after MRA kidney graft transplantation retrospectively.
Materials and Methods: 3089 KT (714 cadaveric and 2375 living-related) have been performed in our center between November 1975 to July 2019. A total of 157 of the graft kidneys had MRA. In MRA grafts, 145 had 2, 10 had 3, 1 had 4, 1 had 5 arteries. Medical records of the patients have been retrospectively evaluated for single renal artery (SRA) graft recipients (Group I) and MRA graft recipients (Group II) respectively.
Results: We found no difference between ischemia time, creatinine clearance, 1st and 5th years creatinine and eGFR levels when we compared the MRA kidney graft recipients and SRA recipients. There was no significant difference between rejection episodes and acute tubular necrosis between Group I and Group II patients as well. Graft survival rates in the 1st and 5th years after transplantation were 93.1% and 79.7% in Group I patients and 92.9% and 78.3  in Group II patients respectively. First and fifth year patient survival rates were showed no significant difference between Group I and Group II (95.5% and 92.9% for SRA and 96.9% and 87.2% for MRA and respectively. Anostomosis duration was 65 minutes in Group I and 74 minutes in Group II patients and accordingly ischemia time was 202 minutes in SRA patients and 214 minutes in MRA patients respectively.
Conclusion: Transplantation of a MRA graft shows equal graft and patient survival rates when compared with SRA graft transplantation in long term.