Impact of additional vascular reconstructions on survival of kidney transplants

Transplanting kidneys with complex vasculature is a demanding procedure and increases the risk of graft failure. The aim of the study was to investigate the outcome of additional vascular reconstructions performed during renal transplantation. In a retrospective analysis, we analyzed 720 consecutive renal transplantations between January 1995 and December 2004. One-week graft survival was the primary endpoint. One-week graft failure occurred in two (0.3%) reconstructed grafts. Arterial reconstructions had no significant effect on the 1-week graft survival [odds ratio (OR), 0.87; 95% confidence interval (CI), 0.85-0.9]. Univariate analysis revealed an increased risk of 1-week graft failure for venous reconstructions (OR, 7.15; 95% CI, 1.17-43.60), especially venous reconstruction without using the caval vein (OR, 27.24; 95% CI, 4.24-176.04). Arterial reconstruction had no increased risk of early renal graft failure. Venous reconstructions had a higher failure rate. This does not apply for reconstructions with the caval vein, of which the results were excellent.