Surgical complications following 1670 consecutive adult renal transplantations: a single center study

Lempinen, Marko; Stenman, Jakob; Kyllönen, L.; Salmela, K.

doi:10.1177/1457496914565419

Cited by 54 publications

(46 citation statements)

References 34 publications

(39 reference statements)

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“…Although they are usually complicated with urinary tract infections (31), graft and patient SR are not affected by surgically-treated urinary complications (30,32,33). There are studies showing that graft SR is impaired in patients with surgical complications as in our study (34,35). Lempinen et al have displayed that 5-year patient and graft SR are 88% and 74% in patients with surgical complications, and 92% and 87% in patients without surgical complications (34).…”

Section: Discussionsupporting

confidence: 57%

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Kumru¹,

Çelebi²,

Aktürk³

et al. 2016

Turk Neph Dial Transpl

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OBJECTIVE:Renal transplantation is the treatment of choice in end-stage renal diseases. Long-term allograft function has remained steady in deceased donor kidney transplantation (DDKTx) during recent decades. In this study, we evaluated DDKTx outcomes at our hospital. MATERIAL and METHODS:72 cadaveric transplant patients who were grafted between January 2002 and October 2013 at our center were analysed retrospectively. Recipients and donors' demographic properties, immunologic and nonimmunologic characteristics, allograft function and emerging complications were examined. Factors associated with graft and patient loss were investigated. RESULTS:Mean follow-up period was 60±38 months. Mean recipient age was 42±11 years, of which 51.4% was male. Dialysis vintage was 83±59 months, while mean cold ischemia time was 12±3 hours. One and five year graft and patient survival rates were 94.4%, 92.3% and 97.2%, 89.9% respectively. High serum creatinine value at discharge (p=0.003) and early surgical complications (p=0.041) were independent risk factors associated with poor graft survival. Having a recipient age ≥46 years (p=0.037) and cardiovascular disease (p=0.017) caused patient loss. Cardiovascular disease was independently associated with patient loss (HR=6.45[1.08-38.70], p=0.041). CONCLUSION:In this study, it was demonstrated that creatinine value at discharge and early surgical complications were associated with allograft loss, while cardiovascular disease was associated with patient loss in DDKTx. BULGULAR: Ortalama takip süresi 60±38 aydır. Alıcıların ortalama yaşı 42±11 yıl, %51.4'ü erkektir. Nakil öncesi ortalama diyaliz süresi 83±59 aydır. Ortalama soğuk iskemi zamanı 12±3 saattir. Bir ve beş yıllık graft sağkalımı sırasıyla %94.4, %92.3; hasta sağkalımı %97.2, %89.9'dur. Hastaneden çıkış kreatinini yüksekliği (p=0.003) ve erken cerrahi komplikasyonların gelişimi (p=0.041) graft sağkalımını olumsuz etkileyen bağımsız risk faktörleridir. Alıcı yaşı≥46 olması (p=0.037) ve kardiyovasküler hastalık gelişimi (p=0.017) hasta kaybını artırmaktadır. Kardiyovasküler hastalık gelişimi hasta kaybı için bağımsız risk faktörüdür (HR=6,], p=0.041).SONUÇ: Çalışmada, kadaverik böbrek nakillerinde hastaneden çıkış kreatinini yüksekliği ve erken cerrahi komplikasyonların gelişiminin allograft kaybını, kardiyovasküler hastalık gelişminin hasta kaybını artırdığı gösterilmiştir.

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Section: Discussionsupporting

confidence: 57%

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Kumru¹,

Çelebi²,

Aktürk³

et al. 2016

Turk Neph Dial Transpl

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“…A more recent series of 1670 consecutive transplants published in 2015 found a urologic complication rate of 8 %. Urine leak occurred in 1.8 % men and 4% women, while ureteral stricture formation was observed in 2.4 % male and 1.2 % female recipients (9). We assume that the slightly higher incidence of ureteral stenosis in our group, compared with the available literature, is related to frequent ultrasonographic check-up of grafts in the post-transplantation period.…”

Section: Discussionmentioning

confidence: 49%

Ureteral Stenosis of Transplanted Kidney

Miklušica

Dedinská

Palkoci

et al. 2017

Acta Medica Martiniana

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A b s t r a c t Introduction: Ureteral stenosis is one of the most commonly reported urological complications after kidney transplantation.Material and methods: This is a retrospective analysis of the risk factors for ureteral stenosis (type of donor, age of donor, presence of interior polar arteria, unilateral dual transplantation, diabetes mellitus of the recipient and the donor, BK positivity, child recipient, cold ischaemia time, and delayed graft function), as well as the causes and types of treating ureteral stenoses.Results: In the group of 278 patients, the occurrence was 7.2 %. The medial of occurrence of ureteral stenoses was 24.6 months. The independent risk factor for ureteral stenosis in our group was the age of the donor ≥ 70 years [HR 6.5833; 95 % CI 2.2448-19,3070 (P = 0.0006)], BK positivity [HR 13.6667; 95 % CI 6.9127-27.0196 (P<0.0001)], cold ischaemia time > 1080 min [HR 4.0368; 95 % CI 1.7250-9,4465 (P = 0.0013)], and diabetes mellitus in the donor´s history [HR 16.2667; 95 % CI 7.8629-33.6525 (P <0.0001)]. The most frequent type of treating the ureteral stenosis in our group was retroureteroneocystostomy. After surgical treatment, we recorded no recurrence of stenosis.Conclusion: In our analysis, the confirmed independent risk factor was diabetes mellitus of the donor. However, further monitoring and analyses of large groups of patients are necessary. Surgical treatment of ureteral stenosis is safe. However, the most important momentum in surgical treatment of ureteral stenosis still remains the surgeon´s experience in the given type of treatment.

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“…Ureteric obstruction is a well-recognised complication of renal transplantation and is seen in up to 4.5% of recipients following surgery 1 2. The majority of obstructions occur within the first year and are caused by stricture formation secondary to devascularisation of the ureter during surgery 3.…”

Section: Discussionmentioning

confidence: 99%

Contralateral inguinal herniation of a transplant ureter causing obstructive uropathy in a renal transplant recipient

Lobo¹,

McCaig

Olsburgh

2017

BMJ Case Reports

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Ipsilateral inguinal herniation of the transplanted ureter has been reported as a rare cause of obstructive uropathy in renal transplant recipients. A 73-year-old man presented with acute renal failure 29 years after receiving a deceased donor renal transplant. Radiological investigations demonstrated marked hydronephrosis of the left iliac fossa transplant kidney and herniation of the distal transplant ureter and bladder into the right inguinal canal. The patient underwent placement of a nephrostomy and antegrade stent followed by definitive hernia repair with return of graft function to baseline level.

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Surgical complications following 1670 consecutive adult renal transplantations: a single center study

Abstract: Surgical complications impair patient and graft survival after kidney transplantation.

Cited by 54 publications

References 34 publications

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Ureteral Stenosis of Transplanted Kidney

Contralateral inguinal herniation of a transplant ureter causing obstructive uropathy in a renal transplant recipient

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Surgical complications following 1670 consecutive adult renal transplantations: a single center study

Abstract: Surgical complications impair patient and graft survival after kidney transplantation.

Cited by 54 publications

References 34 publications

Factors Affecting Allograft and Patient Survival in Deceased Donor ￼Kidney Transplantation: A Single Center Experience in Turkey

Factors Affecting Allograft and Patient Survival in Deceased Donor ￼Kidney Transplantation: A Single Center Experience in Turkey

Ureteral Stenosis of Transplanted Kidney

Contralateral inguinal herniation of a transplant ureter causing obstructive uropathy in a renal transplant recipient

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Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey

Factors Affecting Allograft and Patient Survival in Deceased Donor Kidney Transplantation: A Single Center Experience in Turkey