Complex kidneys for complex patients: the risk associated with transplantation of kidneys with multiple arteries into obese patients

J Nath, S Mastoridis, D van Dellen, D G McGrogan, H Krishnan, N G Inston, A R Ready

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Conflicting evidence surrounds clinical outcomes in obese individuals after transplantation; nonetheless, many are denied the opportunity to receive a transplant. Allografts with complex vascular anatomy are regularly used in both deceased and living donor settings. We established the risk of transplanting kidneys with multiple renal arteries into obese recipients. A retrospective analysis of data from 1095 patients undergoing renal transplantation between January 2004 and July 2013 at a single centre was conducted. Of these, 24.2% were obese (body mass index >30 kg/m(2)), whereas 25.1% of kidneys transplanted had multiple arteries, thereby making the transplantation of kidneys of complex anatomy into obese recipients a relatively common clinical occurrence. Vessel multiplicity was associated with inferior 1-year graft survival (85.8.% vs 92.1%, P = .004). Obese patients had worse 1-graft survival compared to those of normal BMI (86.8% vs 93.8%, P = .001). The risk of vascular complications and of graft loss within a year after transplantation were greater when grafts with multiple arteries were transplanted into obese recipients as compared to their nonobese counterparts (RR 2.00, CI 95% 1.07-3.65, and RR 1.95, CI 95% 1.02-3.65). Additionally, obese patients faced significantly higher risk of graft loss if receiving a kidney with multiple arteries compared to one of normal anatomy (RR 1.97, 95% CI 1.02-3.72). Thus, obese patients receiving complex anatomy kidneys face poorer outcomes, which should be considered when allocating organs, seeking consent, and arranging for aftercare.

Original languageEnglish
Pages (from-to)373-8
Number of pages6
JournalTransplantation Proceedings
Issue number2
Early online date11 Mar 2015
Publication statusPublished - Mar 2015


  • Adult
  • Body Mass Index
  • Female
  • Graft Survival
  • Humans
  • Kidney
  • Kidney Failure, Chronic
  • Kidney Transplantation
  • Living Donors
  • Male
  • Middle Aged
  • Obesity
  • Renal Artery
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome


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