Surgical Complications in 2000 Renal Transplants

Abstract

Introduction. Renal transplantation is the best treatment for end-stage renal disease. In the last years, we have seen improvements in immunosuppressive treatment, which have allowed patients to experience a better quality of life and graft survival. Nevertheless, surgical complications remain important problems that increase morbidity, mortality, costs, and hospitalization. Our purpose was to evaluate surgical complications among a large series of 2000 renal transplantations. Patients and Methods. We retrospectively analyzed all surgical complications among 2000 renal transplants performed between June 1980 and March 2010 in our department. Results. Among 318 (15.9%) surgical complications, 4.8% of patients had urologic problems. Ureteral stenosis and fistula, stent obstruction, and ureteral necrosis occurred in 2.7%, 1.8%, 0.1%, and 0.2% of patients, respectively. Vascular complications reported in 2.7% of patients included arterial or venous thrombosis (1.0% or 0.4%), both arterial and venous thrombosis (0.1%), renal infarction (0.1%), renal artery aneurysm (0.1%) as well as arterial stenosis (0.5%), kinking (0.4%), or dissection (0.1%). Other complications, not specifically related with transplantation surgery, occurred in 4.4% of patients. Conclusion. Renal transplantation is a safe surgery by experienced teams. Our rates of surgical complications were within those reported by other series. A meticulous surgical technique is mandatory to prevent them. Prompt diagnosis and management are required to prevent graft damage and patient morbidity.

Outcomes and Surgical Complications in Kidney Transplantation

“…Surgical complications rarely lead to graft loss, with the exception of vascular pathology [7]. In our study we reported an incidence of 12.7% of surgical complications similar to the 15.9% reported in the literature [8].…”

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“…1 Despite advances in kidney transplant, postoperative vascular complications are major challenges, occurring in 1% to 10% of transplanted patients. [2][3][4][5][6] The most common vascular complications include transplant renal artery stenosis, renal graft arterial or venous thrombosis, and arterial injury, including arteriovenous fistulas, intrarenal pseudoaneurysms, arterial dissection, and arterial-calyceal fistulas. [5][6][7] Transplant renal vein thrombosis (TRVT) of an allograft has a dramatic clinical presentation and is one of the main causes of early graft dysfunction after renal transplant, with a reported prevalence of 0.1% to 4.2 % of all transplants.…”

External Iliac Arterial Obstruction Caused by Satinsky Atrauma Forceps in Renal Transplantation (with Four Case Report)

“…Despite the advances in surgical techniques and immunosuppressive therapies, vascular complications during and after operation remain common, occurring among 3%−15% of all the renal transplant patients (2,3). In the past 10 years, we have completed and gained experience in 1217 cases of renal transplantation.…”