Surgical Complications After Kidney Transplantation

Abstract

Kidney transplants have become common surgical procedures, with thousands performed yearly around the world. The surgical techniques for the transplant are well established and the procedure is associated with high success rates. The complication rate associated with the procedure is low, especially when compared to other abdominal organ transplants such as liver and pancreas transplants. Nonetheless, the detection, accurate diagnosis, and timely management of surgical complications occurring after kidney transplant are important tasks of the team managing these patients. A delay in the diagnosis or management of these complications can result in significant morbidity to the recipient, with risk of graft loss and mortality. Most surgical complications involve either the wound or one of the three anastomoses (renal artery, renal vein, or ureter). Examples include wound infection, renal artery or vein thrombosis, and urine leak. Most of these complications will require surgical or radiologic intervention for appropriate management.

Kidney transplantation: Structural and functional evaluation using MR Nephro‐Urography

“…Reported rates are in the range of less than 1% (45), and may involve either the main transplant renal artery or segmental renal arteries. Thrombosis of the main renal artery is a devastating complication usually resulting in graft failure, and presents with a sudden cessation of urine output.…”

“…The clinical presentation is one of persistent hypertension and/or graft dysfunction. Although common etiologies include iatrogenic causes and atherosclerosis (45,47), postoperative fluid collections may also cause mechanical compression of the transplant artery.…”

“…More advanced cases of postsurgical obstruction are usually due to perinephric fluid collections and blood clots, although sloughed papillae, stones, and prior transplants are more unusual causes (45,47,62). Figure 7 demonstrates a case of a third renal transplant placed into the left renal fossa.…”

“…Postoperative urine collections tend to occur within the first 3 months, usually within 5 weeks after transplant, and are most often due to a leak at the anastomotic site (45). MR demonstrates a perinephric fluid collection with signal characteristics of simple fluid on T2W images, with an absence of high signal blood products on T1W 3D GRE images.…”

Pacientų Gyvybinių Veiklų Vertinimas Ir Komplikacijų Prevencijos Būdai Ankstyvuoju Periodu Po Inksto Transplantacijos

“…Slaugytoja turi pranešti gydytojui, jei nėra diurezės ar ji pranyksta. Inksto venos trombozė dažniausiai pastebima per pirmas 10 dienų po operacijos [9]. Pacientas kartais pats pasako, kad padidėjo transplantuotas inkstas, jis pakietėjęs, atsiranda tempimo jausmas.…”