Resumen
Introduction: Kidney transplantation is the treatment of choice for end-stage renal disease, as it consistently demonstrates better outcomes in overall survival, renal function, and quality of life compared with dialysis therapy. The persistent shortage of organs has led transplant programs to progressively expand donor acceptance criteria, incorporating donors with anatomical variations such as multiple renal arteries. Recent evidence from systematic reviews and meta-analyses indicates that, when an appropriate surgical technique is used and relevant clinical variables are carefully controlled, grafts with multiple renal arteries do not show significant differences in graft survival, renal function, or complication rates compared with those with a single renal artery. Case Presentation: We report the case of a 28-year-old woman with end-stage renal disease due to hemodialysis who underwent a living-donor kidney transplant from a related donor. Three-dimensional computed tomography angiography of the donor identified a left kidney with a single renal vein, a single renal artery, and an inferior polar artery with a significant caliber. These anatomical characteristics resulted in independent arterial anastomoses between the graft arteries and the external iliac artery. The procedure was completed without intraoperative complications, with immediate graft function and adequate graft perfusion confirmed by Doppler ultrasound. Conclusion: This case supports the evidence demonstrating that kidneys with double renal arteries can be safely transplanted and effectively increase the donor pool without compromising clinical outcomes.
Citas
1. Triantafyllou, G., Paschopoulos, I., Węgiel, A., Olewnik, T., Tsakotos, G., Zeilinska, N., [et al]. The accessory renal arteries: a systematic review with meta-analysis. Clin Anat. 2025, Sept.; 38(6): 660–672. DOI: 10.1002/ca.24255
2. George, A.R., Dragan, Z., Gilliatt, F.R.J., Puttaswamy, V., Sariccilar, E. C. Multiple renal arteries in renal transplantation: a systematic review and meta-analysis. ANZ J Surg. 2025, Nov 26; 96(3): 440-448. DOI: 10.1111/ans.70408
3. Huseynov, A., Şengul, H. Effect of multi-artery renal grafts on patient outcomes in living donor kidney transplantation. Langenbecks Arch Surg. 2025, Oct.; 410(1): 312. doi: 10.1007/s00423-025-03880-9
4. Lim EJ, Fong KY, Li J, et al. Single versus multiple renal arteries in living donor kidney transplantation: a systematic review and patient-level meta-analysis. Clin Transplant. 2023;37(11):e15069. doi:10.1111/ctr.15069.
5. Tamara F, Fajar JK, Gersom C, et al. Global prevalence and contributing factors of transplant renal artery stenosis in renal transplant recipients: A systematic review and meta-analysis. Narra J. 2024;4(3):e1782. doi:10.52225/narra.v4i3.1782.
6. Venkatesh KK, Kodakkattil SS, Parameswaran S, et al. Long-term outcomes and survival in patients undergoing multiple vs. single renal artery transplants: a retrospective cohort study. Cureus. 2025;17(1):e78165. doi:10.7759/cureus.78165.Gawish, A.E., Donia, F., Samhan, M., Halinm, M. A., Al-Mousawi, M. Outcome or renal allografts with multiple arteries. Transplant Proc. 2007, May; 39(4): 1116–1117. DOI: 10.1016/j.transproceed.2007.03.067
7. George AR, Dragan Z, Gilliatt FRJ, Puttaswamy V, Saricilar EC. Multiple renal arteries in renal transplantation: a systematic review and meta-analysis. ANZ J Surg. 2026 Mar;96(3):440-448. doi: 10.1111/ans.70408.
8. Riella J, Tabbara MM, Alvarez A, et al. Pediatric kidney transplants with multiple renal arteries show no increased risk of complications compared to single renal artery grafts. Front Pediatr. 2022;10:1058823. doi:10.3389/fped.2022.1058823.
Copyright
License
Copyright (c) 2026 Adonys Hidalgo Lopez, Héctor Rafael Ochomongo García, Juan Sebastian Asteguieta castillo, Carlos Francisco Díaz, Carlos Fernando Herrera Nájera , Sergio Waldemar Macario Nimatuj, Manuel Alejandro Menes Hernández, María Reneé De León Sánchez , Andy Gerardo Fuentes López
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish in this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License 4.0 (CC BY-NC_SA 4.0) that indicates: a) It is allowed that others share the work, with an acknowledgement of the work's authorship and initial publication in this journal, b) The work may not be used for commercial purposes, c) If it's remixed, transformed, or built upon the material, one must distribute the contributions under the same license as the original
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository, website or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
