Evaluating the effect of incision and puncher arteriotomy methods on kidney transplant outcomes: a prospective comparative cohort study

Evaluating the effect of incision and puncher arteriotomy methods on kidney transplant outcomes: a prospective comparative cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluating the effect of incision and puncher arteriotomy methods on kidney transplant outcomes: a prospective comparative cohort study Muhammed Emin Polat, Angelo Territo, Alp Bardakci, Mustafa Karaaslan, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8398350/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose Vascular anastomosis is a critical determinant of graft function and long-term survival in kidney transplantation. The choice of arteriotomy technique may influence hemodynamic flow and early graft outcomes. This prospective study aimed to compare functional and Doppler ultrasonographic outcomes between incision and puncher arteriotomy techniques in kidney transplant recipients. Methods A total of 54 adult kidney transplant recipients were prospectively enrolled and allocated into two groups according to arteriotomy technique: incision (n = 27) and puncher (n = 27). Patients were followed at 0–1 month, 3–6 months, and 6–12 months postoperatively. Renal function tests (creatinine, GFR) and Doppler ultrasonographic parameters, including resistive index (RI) and peak systolic velocity (PSV), were recorded and compared between groups and across time points. Results At the first postoperative month, mean serum creatinine levels were higher in the puncher group compared to the incision group (p = 0.046), while GFR values were similar (p > 0.05). During long-term follow-up (6–12 months), no significant differences were observed between groups in RI, PSV, or GFR (all p > 0.05). Serum creatinine levels remained higher in the puncher group across follow-up (p = 0.021). Peak systolic velocity ratio values at 6–12 months were comparable between groups (p > 0.05). Sex-based analysis revealed higher creatinine levels in male patients at all time points, whereas GFR values did not differ significantly by sex. Conclusions Incision and puncher arteriotomy techniques provide comparable long-term graft function and hemodynamic outcomes in kidney transplantation. When meticulous anastomosis is achieved, either technique may be safely selected based on surgeon preference and vascular anatomy. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8398350","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":577698980,"identity":"e31bd8e5-cab5-4fff-898f-06d6f502afa9","order_by":0,"name":"Muhammed Emin 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study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research 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The choice of arteriotomy technique may influence hemodynamic flow and early graft outcomes. This prospective study aimed to compare functional and Doppler ultrasonographic outcomes between incision and puncher arteriotomy techniques in kidney transplant recipients.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 54 adult kidney transplant recipients were prospectively enrolled and allocated into two groups according to arteriotomy technique: incision (n\u0026thinsp;=\u0026thinsp;27) and puncher (n\u0026thinsp;=\u0026thinsp;27). Patients were followed at 0\u0026ndash;1 month, 3\u0026ndash;6 months, and 6\u0026ndash;12 months postoperatively. Renal function tests (creatinine, GFR) and Doppler ultrasonographic parameters, including resistive index (RI) and peak systolic velocity (PSV), were recorded and compared between groups and across time points.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAt the first postoperative month, mean serum creatinine levels were higher in the puncher group compared to the incision group (p\u0026thinsp;=\u0026thinsp;0.046), while GFR values were similar (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). During long-term follow-up (6\u0026ndash;12 months), no significant differences were observed between groups in RI, PSV, or GFR (all p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Serum creatinine levels remained higher in the puncher group across follow-up (p\u0026thinsp;=\u0026thinsp;0.021). Peak systolic velocity ratio values at 6\u0026ndash;12 months were comparable between groups (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Sex-based analysis revealed higher creatinine levels in male patients at all time points, whereas GFR values did not differ significantly by sex.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIncision and puncher arteriotomy techniques provide comparable long-term graft function and hemodynamic outcomes in kidney transplantation. When meticulous anastomosis is achieved, either technique may be safely selected based on surgeon preference and vascular anatomy.\u003c/p\u003e","manuscriptTitle":"Evaluating the effect of incision and puncher arteriotomy methods on kidney transplant outcomes: a prospective comparative cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-21 14:39:10","doi":"10.21203/rs.3.rs-8398350/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"88f6e54d-23a1-4628-9fe5-f4e2046e74d0","owner":[],"postedDate":"January 21st, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-21T14:45:18+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-21 14:39:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8398350","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8398350","identity":"rs-8398350","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}