Impact of Surgeon's Experience on Vascular and Haemorrhagic Complications After Kidney Transplantation

Kulu, Yakup; Fathi, Parham; Golriz, Mohammad; Khajeh, Elias; Sabagh, Mohammadsadegh; Ghamarnejad, Omid; Mieth, Markus; Ulrich, Alexis; Hackert, Thilo; Müller‐Stich, Beat P.; Strobel, Oliver; Michalski, Christoph; Morath, Christian; Zeier, Martin; Büchler, Markus W.; Mehrabi, Arianeb

doi:10.1016/j.ejvs.2018.07.041

Cited by 21 publications

(12 citation statements)

References 34 publications

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“…5,10,11 Nevertheless, the prolonged use of aP is astonishing as both early and late thromboses are more often related to numerous other factors such as hyperacute rejection by preformed antibodies, surgical experience regarding vessel anastomoses, small vessels in either the donor graft or the recipient, which are not associated with coagulation disorders and therefore cannot be modified by anticoagulants and antiplatelets. 23 Within this context, a limited use of aP for only a few days or weeks following pediatric KTx could be discussed.…”

Section: Discussionmentioning

confidence: 99%

Current practice of antithrombotic prophylaxis in pediatric kidney transplantation—Results of an international survey on behalf of the European Society for Paediatric Nephrology

Buder

Zirngibl

Bapistella

et al. 2020

Pediatric Transplantation

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Section: Discussionmentioning

confidence: 99%

Current practice of antithrombotic prophylaxis in pediatric kidney transplantation—Results of an international survey on behalf of the European Society for Paediatric Nephrology

Buder

Zirngibl

Bapistella

et al. 2020

Pediatric Transplantation

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“…Multidisciplinary evaluation, including consultation of a vascular surgeon, to evaluate the cardiovascular status of kidney transplant candidates could improve the identification of patients at risk for (cardiovascular) death and those who could potentially benefit from interventions to improve their prognosis after transplantation [5][6][7]. When screening kidney transplant candidates, evaluation generally includes traditional risk factors, as used in risk prediction scores for the general population (i.e., the Framingham score), and transplant candidate-specific risk factors, with among others chronic kidney disease-mineral bone disorder (CKD-MBD) [8,9].…”

Section: Introductionmentioning

confidence: 99%

Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

Benjamens

Rijkse

Velde-Keyzer

et al. 2020

JCM

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As vascular calcification is common in kidney transplant candidates, aorto-iliac vessel imaging is performed for surgical planning. The aim of the present study was to investigate whether a novel non-contrast enhanced computed tomography-based quantification technique for aorto-iliac calcification can be used for cardiovascular risk stratification prior to kidney transplantation. In this dual-center cohort study, we measured the aorto-iliac calcium score (CaScore) of 547 patients within three years prior to transplantation (2005–2018). During a median (interquartile range) follow-up of 3.1 (1.4, 5.2) years after transplantation, 80 (14.7%) patients died, of which 32 (40.0%) died due to cardiovascular causes, and 84 (15.5%) patients had a cardiovascular event. Kaplan-Meier survival curves showed significant differences between the CaScore tertiles for cumulative overall-survival (Log-rank test p < 0.0001), cardiovascular survival (p < 0.0001), and cardiovascular event-free survival (p < 0.001). In multivariable Cox regression, the aorto-iliac CaScore was associated with all-cause mortality (hazard ratio 1.53, 95%CI 1.14–2.06, p = 0.005), cardiovascular mortality (2.04, 1.20–3.45, p = 0.008), and cardiovascular events (1.35, 1.01–1.80, p = 0.042). These independent associations of the aorto-iliac CaScore with the outcome measures can improve the identification of patients at risk for (cardiovascular) death and those who could potentially benefit from stringent cardiovascular monitoring to improve their prognosis after transplantation.

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“…Transplant surgery has become more complex, especially at the vascular level due to the aging of donors and recipients [24]. Kulu et al [25] reported the young age of a surgeon as a risk factor of vascular and hemorrhagic complications after kidney transplantation.…”

Section: Discussionmentioning

confidence: 99%

The weekend effect in kidney transplantation outcomes: a French cohort‐based study

et al. 2020

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Summary Numerous studies have reported a weekend effect on outcomes for diseases treated at hospitals. No study has been conducted in France for kidney transplantation. We therefore performed a cohort‐based study to evaluate whether outcomes of kidney transplant recipients display a weekend effect. Data were extracted from the French DIVAT cohort. Patients aged 18 years and older, transplanted with a single kidney from deceased donors between 2005 and 2017 were studied. Linear regression, logistic regression, and cause‐specific Cox model were used. Among the 6652 studied patients, 4653 patients were transplanted during weekdays (69.9%) versus 1999 during weekends (30.1%). The only statistically significant difference was the percentage of patients with vascular surgical complication(s) at 30 days: 13.3% in the weekend group versus 16.2% in the weekday group 0.79 (95% CI: 0.68; 0.92). We did not observe other significant differences for the other outcomes: patient or graft survival, the risk of acute rejection episodes, the 30‐day percentage of urological complications, and the 1‐year estimated glomerular filtration rate. Our study highlights a small protective weekend effect with less post‐surgery vascular complications compared to weekdays. This paradox might be explained by a different handling of weekend transplantations.

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Impact of Surgeon's Experience on Vascular and Haemorrhagic Complications After Kidney Transplantation

Cited by 21 publications

References 34 publications

Current practice of antithrombotic prophylaxis in pediatric kidney transplantation—Results of an international survey on behalf of the European Society for Paediatric Nephrology

Current practice of antithrombotic prophylaxis in pediatric kidney transplantation—Results of an international survey on behalf of the European Society for Paediatric Nephrology

Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

The weekend effect in kidney transplantation outcomes: a French cohort‐based study

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