Burdened urological history as a risk factor in kidney transplantation for older age group recipients

Abstract

Introduction. Chronic renal failure develops more often in elderly patients after previous repeated urological operations. Urological diseases are an important additional factor that multiply complicates kidney transplantation due to the need for preliminary correction of existing disorders. Not to mention the fact that the recipient's advanced age contributes to the risk of developing graft dysfunction due to the presence of concomitant diseases that worsen the immediate and long-term results of transplantation. Material and methods. We carried out the analysis of clinical observations and studies performed in 124 patients who underwent cadaveric renal allotransplantation at the N.V. Sklifosovsky Research Institute for Emergency Medicine, including from suboptimal donors. Of these, 69 (55.6%) recipients older than 60 years were included in the main group (group 1), and 55 recipients younger than 60 years (44.4%) -in the comparison group (group 2). From the patients of group 1, patients with urological diseases that led to the development of terminal chronic renal failure, or with previously undergone surgeries for urological diseases (subgroup 1A, 43 patients) were isolated. The remaining 26 patients who did not have urological diseases were put in subgroup 1B. Results. The analysis showed that in the early postoperative period in the recipients of group 1, complications developed in almost all the patients (80 complications in 64 of 69 patients, that is, 92.8% of patients in this group), whereas in group 2, complications developed only in 30.9% of patients (27 complications in 17 of 55 patients). At the same time, on average, 1.2 complications per 1 patient were noted in group 1, and 0.5 complications per 1 patient in group 2, a significant part of the complications occurred in the subgroup of patients with a burdened urological history (subgroup 1A). Late complications also developed statistically significantly more often (almost 2 times) in recipients with a burdened urological history. Conclusions. Complications of the early and late postoperative period develop statistically significantly more often in elderly recipients. The presence of a burdened urological history in elderly recipients significantly increases the risk of early and late postoperative complications.