Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Nov;37(11):e15069.
doi: 10.1111/ctr.15069. Epub 2023 Jul 6.

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient-level meta-analysis

Ee Jean Lim  1 , Khi Yung Fong  2 , Jingqiu Li  1 , Yiong Huak Chan  3 , Edwin Jonthan Aslim  1 , Lay Guat Ng  1   4 , Valerie Huei Li Gan  1   4
Affiliations
Meta-Analysis

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient-level meta-analysis

Ee Jean Lim et al. Clin Transplant. 2023 Nov.

Abstract

Introduction: Grafts with multiple renal arteries (MRAs) were historically considered a relative contraindication to transplantation due to the higher risk of vascular and urologic complications. This study aimed to evaluate graft and patient survival between single renal artery (SRA) and MRA living-donor kidney transplants.

Methods: An electronic literature search was conducted on PubMed, EMBASE, and Scopus for prospective or retrospective studies comparing SRA versus MRA in living donor renal transplantation, with the provision of Kaplan-Meier curves for recipient overall survival (OS) or graft survival (GS). A graphical reconstructive algorithm was used to obtain OS and GS of individual patients, which was then pooled under random-effects individual patient data (IPD) meta-analysis using Cox-models to determine hazard ratios (HRs) and 95% confidence intervals (CIs). Meta-regression of baseline covariates versus HRs of OS and GS was performed for variables reported in 10 or more studies.

Results: Fourteen studies were retrieved, of which 13 (8400 patients) reported OS and 9 (6912 patients) reported GS. There were no significant differences in OS (shared-frailty HR = .94, 95%CI = .85-1.03, p = .172) or GS (shared-frailty HR = .95, 95%CI = .83-1.08, p = .419) between SRA and MRA. This comparison remained non-significant even when restricted to open- or laparoscopic-only studies. Meta-regression yielded no significant associations of GS with donor age, recipient age, and percentage of double renal arteries within the MRA arm.

Conclusions: The similar rates of GS and OS between MRA and SRA grafts suggest that there is no need for discrimination between the two when evaluating donors for nephrectomy.

Keywords: graft survival; living donor kidney transplantation; multiple renal arteries.

PubMed Disclaimer

References

REFERENCES

    1. Wang JH, Hart A. Global Perspective on Kidney Transplantation: United States. Kidney360. 2021;2(11):1836.
    1. Lee L-Y, Pham TA, Melcher ML. Living Kidney Donation: Strategies to Increase the Donor Pool. Sur Clin. 2019;99(1):37-47.
    1. Kälble T, Lucan M, Nicita G, Sells R, Revilla FJB, Wiesel M. Eau Guidelines on Renal Transplantation. Eur Urol. 2005;47(2):156-166.
    1. Afriansyah A, Rasyid N, Rodjani A, et al. Laparoscopic procurement of single versus multiple artery kidney allografts: Meta-analysis of comparative studies. Asian J Surg. 2019;42(1):61-70.
    1. Zorgdrager M, Krikke C, Hofker SH, Leuvenink HG, Pol RA. Multiple Renal Arteries in Kidney Transplantation: A Systematic Review and Meta-Analysis. Ann Transplant. 2016;21:469-478.

LinkOut - more resources