25 a Corresponding Adress: Dr. SOYER Vural, Inonu University Faculty of Medicine, Department of General Surgery, Malatya, Turkey Phone: +90 422 3410660 e-mail: hvuralsoyer@yahoo.com Received/Geliş Tarihi:04.09.2014 Accepted/Kabul Tarihi: 09.10.2014 * This study has been sent to inform the Tx2014 Congress. Fırat Tıp Derg/Firat Med J 2015; 20(1): 25-28 Clinical Research Multiple Renal Arteries in Patients with Kidney Transplantation: Initial Experiences of The New Kidney Transplant Center Sertac USTA, Vural SOYER a , Barıs SARICI, Turgut PISKIN, Bulent UNAL 1 Inonu University Faculty of Medicine, Department of General Surgery, Malatya, Turkey ABSTRACT Objective: Multiple renal artery grafts of kidney transplant patients developing complications and results for long-term kidney function were evaluated. Material and Method: From 2010 to 2014, 115 kidney transplant patients were evaluated retrospectively. A sum of, 115 donor nephrectomies were performed in our instution. Kidney were transplanted with a single artery to 99 patients and sixteen (approximate 14%) with more than one. For five of these 16 patients, the organs were transplanted from a cadaver and eleven were transplanted from living donors. Results: Mean age was 38,5 years (range 9–58 years), mean follow up time was 22,5 month (min. 3,5 and max. 41 month) and mean cold ischemia time was 153 minutes for living donor transplantations and 1396 minutes for cadaveric transplantation, and also warm ischemia time was 236 seconds for living donor transplantation. In all cases, the grafted kidney began to function immediately after reperfusion. Fourteen of the recipients had no any early kidney dysfunction, a problem that is usually attributed to prolonged anastomosis time. Conclusion: Transplanting kidneys with multiple renal arteries may result in significant risks. Prolonged cold or hot ischemia time may elevate incidence of non functional graft and rejection. Results of this study points that unifying artery anastomosis at the backtable would reduce the risk. Key Words: Kidney transplantation, Multiple arteries, Ischemia. ÖZET Böbrek Naklinde Çoklu Arter: Yeni Bir Böbrek Transplant Merkezinin Başlangıç Deneyimi Amaç: Birden fazla renal arter anastomozu yapılan böbrek nakilli hastalarda gelişen komplikasyonlar ve uzun dönem nakil böbrek fonksiyon sonuçlarını değerlendirmek. Gereç ve Yöntem: 2010 ile 2014 yılları arasında yapılan 115 böbrek nakil hastasının verilerini geriye dönük olarak inceledik. Toplamda 115 donör nefrektomi ameliyatı gerçekleştirildi. Bunlardan 99 tanesinde transplante edilen böbrekte tek ve 16 tanesinde (yaklaşık %16) ise birden fazla renal arter vardı. Bu 16 hastadan 5 tanesine kadavra ve 11 tanesinide canlı donörden böbrek nakli yapıldı. Bulgular: Çalışmaya dahil edilen hastaların ortalama yaşı 38,5 (9-58 yaş arası) ve ortalama takip süreleride 22,5 ay ( en az 3,5 ay ve en fazla 41 ay) idi. Kadavradan yapılan nakillerde ortalama soğuk iskemi süresi 1396 dakika iken canlı vericili böbrek nakillerinde bu süre 153 dakika olarak ölçüldü. Aynı zamnda canlı vericili böbrek nakillerinde sıcak iskemi süreside 236 saniye olarak ölçüldü. Vakaların tümünde reperfüzyonu takiben böbrek fonksiyonları hemen başladı. 14 vakada erken dönemde böbrek fonksiyonlarından herhangi birinde bozukluk olmadı. Sonuç: Böbrek naklinde birden çok arter anastomozu bazı riskler taşır. Uzamış sıcak ve soğuk iskemi sürelerine bağlı sıklıkla greft fonksiyon kaybı ve rejeksiyonu gözlenebilir. Backtable işlemi sırasında yapılan iyi bir hazırlık ile iskemi süresi artmadan greft fonksiyonları korunarak multiple arterli hastalarda güvenle böbrek nakli yapılması daha uygun olacaktır. Anahtar Kelimeler: Böbrek nakli, Çoklu arter, İskemi. Renal transplantation is the current definitive treatment option for end stage renal failure (1) due to developing of surgical techniques and postoperative immunosuppression. In developing countries, major sources of transplanted organs are living donors. Donors are evaluated for renal vascular abnormalities with computerized tomography (CT) or magnetic resonans imaging (MRI) preoperatively. Most common vascular abnormaliy is existence of multiple renal arteries. This means that previous contraindications in the past are currently just one more challenge to overcome. Their existence results in prolongation of operation time and may increase risk of graft failure (tubular necrosis, delayed graft function and even rejection) (2, 3). The aim of this study is to search outcome and complication rate differences of patients with only one artery and with multiple arteries compared with the