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The influence of surgical complications on renal graft function


Authors: Slavomír Rokošný 1;  Peter Baláž 1;  Peter Wohlfahrt 2;  Libor Janoušek 1;  Miloš Adamec 1
Authors‘ workplace: Institut klinické a experimentální medicíny Praha, Klinika transplantační chirurgie 1;  Institut klinické a experimentální medicíny Praha, Pracoviště preventivní kardiologie 2
Published in: Čas. Lék. čes. 2011; 150: 75-78
Category: Original Article

Overview

Background:
Kidney transplantation is the method of choice for patients with end stage kidney disease. Surgical complications remain a serious clinical problem and can lead to loss of graft function.

Aim:
Analysis of surgical complications in patients after single kidney transplant from cadaver donors and their influence on the function of the transplanted graft.

Methods:
Patients after a single kidney transplant from a cadaver donor (n = 566) between 1/2006–4/2009 in the Institute of Clinical and Experimental Medicine.

Results:
Individual surgical complications did not affect the delayed onset of graft function. A significantly higher serum creatinine in the 3rd month was observed in the group of patients with urinary leak (p = 0.02) compared with a group of patients without complications. The serum creatinine at 6th month was not affected by any surgical complication. Serum creatinine at 12th month was statistically significantly higher in the group of patients with lymphocele (p = 0.028) compared with a group of patients without complications. The surgical complications which had a significant effect on one year graft survival were infectious wound complications in the recipient (p < 0.05), renal artery stenosis (p < 0.05) and renal vein thrombosis (p < 0.01).

Conclusions:
The onset of graft function was not affected by surgical complications. The group of patients with urinary leak had higher serum creatinine in 3rd month and patients with lymphocele in 12th month. Infectious wound complications, renal artery stenosis and renal vein thrombosis decrease the 1-year graft survival.

Key words:
kidney transplantation, surgical complications, graft survival.


Sources

1. Humar A, Matas AJ. Surgical complications after kidney transplantation. Semin Dial 2005; 18(6): 505–510.

2. Hernández D, Rufino M, Bartolomei S, González-Rinne A, Lorenzo V, Cobo M, Torres A. Clinical impact of preexisting vascular calcifications on mortality after renal transplantation. Kidney Int 2005; 67(5): 2015–2020.

3. Kamali K, Zargar MA, Zargar H. Early common surgical complications in 1500 kidney transplantations. Transplant Proc 2003; 35(7): 2655–2656.

4. Barba Abad J, Rincón Mayans A, Tolosa Eizaguirre E, Romero Vargas L, Rosell Costa D, Robles García JE, Zudaire Bergera JJ, Berián Polo JM, Piédrola IP. Surgical complications in kidney transplantation and their influence on graft survival. Actas Urol Esp 2010; 34(3): 266–273.

5. Hernández D, Rufino M, Armas S, González A, Gutiérrez P, Barbero P, Vivancos S, Rodríguez C, de Vera JR, Torres A. Retrospective analysis of surgical complications following cadaveric kidney transplantation in the modern transplant era. Nephrol Dial Transplant 2006; 21(10): 2908–2015.

Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management

Article was published in

Journal of Czech Physicians


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