Vascular Multiplicity Should Not Be a Contra-Indication for Live Kidney Donation and Transplantation

Whether vascular multiplicity should be considered as contraindication and therefore 'extended donor criterion' is still under debate. Data from all live kidney donors from 2006-2013 (n = 951) was retrospectively reviewed. Vascular anatomy as imaged by MRA, CTA or other modalities was comp...

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Published in:PloS one Vol. 11; no. 4; p. e0153460
Main Authors: Lafranca, Jeffrey A, van Bruggen, Mark, Kimenai, Hendrikus J A N, Tran, Thi C K, Terkivatan, Türkan, Betjes, Michiel G H, IJzermans, Jan N M, Dor, Frank J M F
Format: Journal Article
Language:English
Published: United States Public Library of Science 14-04-2016
Public Library of Science (PLoS)
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Summary:Whether vascular multiplicity should be considered as contraindication and therefore 'extended donor criterion' is still under debate. Data from all live kidney donors from 2006-2013 (n = 951) was retrospectively reviewed. Vascular anatomy as imaged by MRA, CTA or other modalities was compared with intraoperative findings. Furthermore, the influence of vascular multiplicity on outcome of donors and recipients was studied. In 237 out of 951 donors (25%), vascular multiplicity was present. CTA had the highest accuracy levels regarding vascular anatomy assessment. Regarding outcome of donors with vascular multiplicity, warm ischemia time (WIT) and skin-to-skin time were significantly longer if arterial multiplicity (AM) was present (5.1 vs. 4.0 mins and 202 vs. 178 mins). Skin-to-skin time was significantly longer, and complication rates were higher in donors with venous multiplicity (203 vs. 180 mins and 17.2% vs. 8.4%). Outcome of renal transplant recipients showed a significantly increased WIT (30 vs. 26.7 minutes), higher rate of DGF (13.9% vs. 6.9%) and lower rate of BPAR (6.9% vs. 13.9%) in patients receiving a kidney with AM compared to kidneys with singular anatomy. We conclude that vascular multiplicity should not be a contra-indication, since it has little impact on clinical outcome in the donor as well as in renal transplant recipients.
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Conceived and designed the experiments: JAL JNMI FJMFD. Performed the experiments: JAL MvB HJANK TCKT TT FJMFD. Analyzed the data: JAL MvB FJMFD. Wrote the paper: JAL MvB MGHB JNMI FJMFD.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0153460