Results of anastomosis of accessory lower polar graft artery to internal iliac artery in renal transplantation

Abstract

Background: Our objective is to perform a renal graft transplant using multiple arteries where the lower polar artery will indeed be anastomosed to the internal iliac artery end to side following declamping the main arterial supply in terms of ischemia time, diuresis, graft perfusion, and postoperative clinical parameters and investigations. Methods: Fifty live donors underwent vascular anastomosis of the graft auxiliary lower polar artery to recipient internal iliac artery end to side anastomosis with various renal arteries bilaterally, including lower polar artery in chosen kidney. The recipients' intraoperative warm and total ischemia periods, as well as their postoperative incidence of acute tubular necrosis, were assessed (ATN). Diuresis, urinary output, and creatinine levels at 1, 3, and 5 days after surgery, as well as at 2 months afterwards. MRI and Doppler ultrasonography, if necessary. Results: In contrast to warm, the mean total ischemia time was 20.86 minutes. Low incidence of ATN (8%) was controlled and postoperative recovery went without a hitch. Regarding postoperative urine output and serum creatinine level monitoring, clinical and laboratory indicators were satisfactory. Depending on the assessment method, colour Doppler ultrasonography reveals well perfused transplanted grafts with a satisfactory peak systolic velocity ratio in the auxiliary graft artery.