Number of Donor Renal Arteries and Early Outcomes After Deceased Donor Kidney Transplantation

Background: Anatomical abnormalities increase the risk of deceased donor kidney discard but their impact on transplant outcomes is understudied. We sought to determine the impact of multiple donor renal arteries on early outcomes after deceased donor kidney transplantation. Methods: For this retrospective cohort study, we identified 1443 kidneys from 832 deceased donors with ≥1 kidney transplanted at our center (2006-2016). We compared the odds of delayed graft function and 90-day graft failure using logistic regression. To reduce potential selection bias, we then repeated the analysis using a paired-kidney cohort including kidney pairs from 162 donors with 1 single-artery kidney and 1 multi-artery kidney. Results: Of 1443 kidneys included, 319 (22%) had multiple arteries. Multi-artery kidneys experienced longer cold ischemia time, but other characteristics were similar between groups. Delayed graft function (50% multi-artery vs 45% one artery, p=0.07) and 90-day graft failure (3% vs 3%, p=0.83) were similar between groups before and after adjusting for donor and recipient characteristics. In the paired kidney analysis, cold ischemia time was significantly longer for multi-artery kidneys compared to single-artery kidneys from the same donor (33.5 versus 26.1 hours, p