Surgical complications associated with renal transplantation, experience at the Hospital de Clínicas
DOI:
https://doi.org/10.70108/nefrologiapy.2023.1.1.28Keywords:
surgical complications, renal transplantation, heterologous transplantationAbstract
Introduction: Surgical complications can occur after renal transplantation, leading to graft loss. For this reason, it is important to diagnose complications early and establish an adequate treatment.
Objective: To analyze the surgical complications associated with kidney transplantation in patients from the Nephrology Department of the Hospital de Clínicas from November 2014 to October 2018.
Method: Observational, descriptive cross-sectional study. Consecutive cases of kidney transplant patients at the Hospital de Clínicas. The sample consisted of 108 transplant patients in the Department of Nephrology in said period.
Results: 108 kidney transplant patients were evaluated, 70 (64.8%) from living donors and 38 (35.2%) from cadaveric donors. The mean age was 38.6 ± 13.6 years, 72.3% were male, 65.1% were from urban areas, and dialysis time before transplantation was 21.2 ± 30.1 months. The etiology of chronic kidney disease was diabetic nephropathy 14.8%, unknown 60.1%. The age at the time of ablation was 61.1 ± 18.5 years. Seventeen (15.7%) patients presented some surgical complication; 8 (47.2%) occurred in patients transplanted from cadaveric donors and 9 (52.8%) from living donors. Complications were: ureterovesical stenosis in 2 patients (11.7%), followed by urinary fistula, renal vein thrombosis of the graft, and renal artery thrombosis of the transplanted kidney in the same number and percentage. Mortality was 3.6% due to causes other than surgical. There was graft loss in 3.6% associated with vascular surgical complications. There was no association of the different variables studied with the appearance of complications of the surgical type (p>0.05).
Conclusion: The figures for surgical complications related to the transplant were low (15.7%). There were vascular complications such as graft thrombosis, urinary fistulas, and ureteral stenosis, 5.8% for urinoma, deep vein thrombosis of the lower limbs associated with renal hematoma, active arterial bleeding from the bed, lymphocele, uretero-pyelocutaneous fistula, stenosis of the renal artery graft, respectively for each of the cases. Overall mortality was not associated with surgical complications. Graft loss in the population studied was associated with vascular surgical complications. None of the variables studied had statistical significance with the appearance or not of surgical complications.
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Copyright (c) 2023 luana Maciel, Lilian Gómez, Vicente Quiñonez, Pedro Vera, Rossana Vera, Norma Arévalos, Manuel López, Idalina Stanley, Lourdes Carolina Vázquez Jiménez, Fernando Da Ponte
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