Impact of Anastomosis Time on Early Renal Graft Function: Slow Can Be Better

Qaisar Iqbal¹, Taqi F Toufeeq Khan¹*, Muneeb Hassan¹, Irfan Mirza², Tahir Rashid² and Nisar Anwar^2
1Kidney Transplant Unit, department of transplant surgery, Rehman Medical Institute Peshawar
²Kidney Transplant Unit, Department of nephrology, Rehman Medical Institute Peshawar
*Corresponding Author: Taqi F Toufeeq Khan, Head of department. Kidney transplant unit, Rehman Medical Institute Peshawar, Pakistan.

Published: October 28, 2023

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Abstract  

Introduction: Prolonged recipient warm ischemia can cause delayed graft function (DGF), resulting in poor graft outcomes. Short Anastomosis times (AT) are considered beneficial for prompt early graft function (EGF).

Objective: We examined the impact of prolonged AT on EGF.

Materials and Methods: A retrospective cohort study of 120 living donor renal transplants (LDRT) performed between January 2019 and March 2022 at the Renal Transplant Unit of Rehman Medical Institute, Peshawar. The study population was divided into two groups based on AT; GI with AT less than 40 minutes, GII with AT more than 40 minutes. Cold saline irrigation was used to maintain low graft temperature during implantation.

Results: Four patients had poor EGF (3.33%), two DGF (1.67%) and two SGF (1.67%). Mean AT in GI was 37.23±1.93 vs mean AT in GII 47.07±6.90 (p value .00001). Time taken for 50% reduction in serum creatinine (SC) (SC50), SC at discharge, and last SC in both groups were comparable. No significant difference was found in incidence of poor EGF in the 2 groups (OR 0.19, 95% CI, P=0.355).

Conclusion: In the presence of low graft temperatures, prolonged AT did not adversely affect EGF.

Keywords: recipient warm ischemia; anastomosis time; early graft function

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