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10.1371/journal.pone.0199629

http://scihub22266oqcxt.onion/10.1371/journal.pone.0199629
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C6040747!6040747!29995911
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suck abstract from ncbi


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pmid29995911      PLoS+One 2018 ; 13 (7): ä
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  • Inferior long-term graft survival after end-to-side reconstruction for two renal arteries in living donor renal transplantation #MMPMID29995911
  • Yamanaga S; Rosario A; Fernandez D; Kobayashi T; Tavakol M; Stock PG; Kang SM
  • PLoS One 2018[]; 13 (7): ä PMID29995911show ga
  • Living donor kidneys with two arteries can be revascularized using various techniques depending on anatomy. We hypothesized that the revascularization technique could impact long-term outcomes. We retrospectively analyzed 1714 living donor renal transplants at our institution between 1999 and 2015. Three hundred and eleven kidneys had dual arteries, and these were categorized into 5 groups; end-to-side (n = 18), inferior epigastric artery (n = 21), direct anastomosis (n = 65), side-to-side (n = 126) and ligated (n = 81). We then compared the outcomes with that of a control group (single artery, n = 1403) using Kaplan-Meier and Cox regression analyses. Cox regression was adjusted by age, sex and race/ethnicity of donor and recipient, side of kidney, transplant period and recipient surgeon. Compared to the control group, the end-to-side group had increased all-cause graft loss (10 years: 77.2% vs 24.5%, adjusted hazard ratio [aHR] 3.02, 95% confidence interval [CI] 1.30?7.03, p = 0.010) and death-censored graft loss (10 years: 82.0% vs 55.9%, aHR 4.17, 95% CI 1.63?10.68, p = 0.003), whereas the other groups did not. Our study shows that 10-year overall survival and death-censored graft survival were significantly worse for end-to-side arterial reconstruction than for other techniques. Alternative techniques to the end-to-side method should be used for accessory arteries that require revascularization.
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