S Ali Husain1,2, Kristen L King1,2, Shelief Robbins-Juarez1, Joel T Adler3,4, Kasi R McCune5, Sumit Mohan1,2,6. 1. Division of Nephrology, Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York. 2. The Columbia University Renal Epidemiology Group, New York, New York. 3. Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts. 4. Center for Surgery and Public Health at Brigham and Women's Hospital, Boston, Massachusetts. 5. Department of Surgery, Kidney and Pancreas Transplant Program, Columbia University College of Physicians & Surgeons, New York, New York. 6. Department of Epidemiology, Mailman School of Public Health, New York, New York.
Abstract
Background: Anatomic abnormalities increase the risk of deceased donor kidney discard, but their effect on transplant outcomes is understudied. We sought to determine the effect of multiple donor renal arteries on early outcomes after deceased donor kidney transplantation. Methods: For this retrospective cohort study, we identified 1443 kidneys from 832 deceased donors with ≥1 kidney transplanted at our center (2006-2016). We compared the odds of delayed graft function and 90-day graft failure using logistic regression. To reduce potential selection bias, we then repeated the analysis using a paired-kidney cohort, including kidney pairs from 162 donors with one single-artery kidney and one multiartery kidney. Results: Of 1443 kidneys included, 319 (22%) had multiple arteries. Multiartery kidneys experienced longer cold ischemia time, but other characteristics were similar between groups. Delayed graft function (50% multiartery versus 45% one artery, P=0.07) and 90-day graft failure (3% versus 3%, P=0.83) were similar between groups before and after adjusting for donor and recipient characteristics. In the paired kidney analysis, cold ischemia time was significantly longer for multiartery kidneys compared with single-artery kidneys from the same donor (33.5 versus 26.1 hours, P<0.001), but delayed graft function and 90-day graft failure were again similar between groups. Conclusions: Compared with single-artery deceased donor kidneys, those with multiple renal arteries are harder to place, but experience similar delayed graft function and early graft failure.
Background: Anatomic abnormalities increase the risk of deceased donor kidney discard, but their effect on transplant outcomes is understudied. We sought to determine the effect of multiple donor renal arteries on early outcomes after deceased donor kidney transplantation. Methods: For this retrospective cohort study, we identified 1443 kidneys from 832 deceased donors with ≥1 kidney transplanted at our center (2006-2016). We compared the odds of delayed graft function and 90-day graft failure using logistic regression. To reduce potential selection bias, we then repeated the analysis using a paired-kidney cohort, including kidney pairs from 162 donors with one single-artery kidney and one multiartery kidney. Results: Of 1443 kidneys included, 319 (22%) had multiple arteries. Multiartery kidneys experienced longer cold ischemia time, but other characteristics were similar between groups. Delayed graft function (50% multiartery versus 45% one artery, P=0.07) and 90-day graft failure (3% versus 3%, P=0.83) were similar between groups before and after adjusting for donor and recipient characteristics. In the paired kidney analysis, cold ischemia time was significantly longer for multiartery kidneys compared with single-artery kidneys from the same donor (33.5 versus 26.1 hours, P<0.001), but delayed graft function and 90-day graft failure were again similar between groups. Conclusions: Compared with single-artery deceased donor kidneys, those with multiple renal arteries are harder to place, but experience similar delayed graft function and early graft failure.
Authors: Thomas Bessede; Stephane Droupy; Yacine Hammoudi; Dina Bedretdinova; Antoine Durrbach; Bernard Charpentier; Gerard Benoit Journal: Transpl Int Date: 2012-07-21 Impact factor: 3.782
Authors: Robert M Merion; Valarie B Ashby; Robert A Wolfe; Dale A Distant; Tempie E Hulbert-Shearon; Robert A Metzger; Akinlolu O Ojo; Friedrich K Port Journal: JAMA Date: 2005-12-07 Impact factor: 56.272
Authors: M Kwapisz; R Kieszek; M Bieniasz; K Jędrzejko; M Nita; K Sułkowska; P Palczewski; M Durlik; L Pączek; A Kwiatkowski Journal: Transplant Proc Date: 2018-03-28 Impact factor: 1.066
Authors: Syed Ali Husain; Mariana C Chiles; Samnang Lee; Stephen O Pastan; Rachel E Patzer; Bekir Tanriover; Lloyd E Ratner; Sumit Mohan Journal: Clin J Am Soc Nephrol Date: 2017-12-07 Impact factor: 8.237
Authors: Christiane Kugler; Jens Gottlieb; Gregor Warnecke; Anke Schwarz; Karin Weissenborn; Hannelore Barg-Hock; Christoph Bara; Ina Einhorn; Axel Haverich; Hermann Haller Journal: Transplantation Date: 2013-08-15 Impact factor: 4.939
Authors: Hessel Peters-Sengers; Julia H E Houtzager; Mirza M Idu; Martin B A Heemskerk; Ernst L W van Heurn; Jaap J Homan van der Heide; Jesper Kers; Stefan P Berger; Thomas M van Gulik; Frederike J Bemelman Journal: Transplant Direct Date: 2019-04-25
Authors: Andrea Gibbons; Janet Bayfield; Marco Cinnirella; Heather Draper; Rachel J Johnson; Gabriel C Oniscu; Rommel Ravanan; Charles Tomson; Paul Roderick; Wendy Metcalfe; John L R Forsythe; Christopher Dudley; Christopher J E Watson; J Andrew Bradley; Clare Bradley Journal: BMJ Open Date: 2021-04-14 Impact factor: 2.692