Objective: Multiple renal artery grafts of kidney transplant patients developing complications and results for long-term kidney function were evaluated.

Material and Method: From 2010 to 2014, 115 kidney transplant patients were evaluated retrospectively. A sum of, 115 donor nephrectomies were performed in our instution. Kidney were transplanted with a single artery to 99 patients and sixteen (approximate 14%) with more than one. For five of these 16 patients, the organs were transplanted from a cadaver and eleven were transplanted from living donors.

Results: Mean age was 38,5 years (range 9–58 years), mean follow up time was 22,5 month (min. 3,5 and max. 41 month) and mean cold ischemia time was 153 minutes for living donor transplantations and 1396 minutes for cadaveric transplantation, and also warm ischemia time was 236 seconds for living donor transplantation. In all cases, the grafted kidney began to function immediately after reperfusion. Fourteen of the recipients had no any early kidney dysfunction, a problem that is usually attributed to prolonged anastomosis time.

Conclusion: Transplanting kidneys with multiple renal arteries may result in significant risks. Prolonged cold or hot ischemia time may elevate incidence of non functional graft and rejection. Results of this study points that unifying artery anastomosis at the backtable would reduce the risk.