Surgical Complications After Deceased Donor Renal Transplant

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Kozan R., Sözen H., Sapmaz A., Dalgiç A.

EXPERIMENTAL AND CLINICAL TRANSPLANTATION, sa.9, ss.914-918, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2021
  • Doi Numarası: 10.6002/ect.2020.0554
  • Dergi Adı: EXPERIMENTAL AND CLINICAL TRANSPLANTATION
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.914-918
  • Anahtar Kelimeler: Deceased donor, Kidney transplant, Outcome, KIDNEY-TRANSPLANTATION, UROLOGICAL COMPLICATIONS, VASCULAR COMPLICATIONS, SURVIVAL, DIALYSIS
  • Gazi Üniversitesi Adresli: Evet

Özet

Objectives: Deceased donor renal transplant is an accepted treatment for patients with end-stage renal disease. We retrospectively analyzed urological and surgical complications and outcomes in our series. Material and Methods: Since 2016, we have performed 263 renal transplants at the Gazi University Transplantation Center, Ankara, and 92 of these were from deceased donors. We retrospectively analyzed outcomes of these 92 deceased donor transplants from our database records. There were 45 female and 47 male recipients, and 20 were pediatric recipients. Mean recipient and donor ages were 36 +/- 14 and 38 +/- 18 years old, respectively. Immunosuppression therapy con sisted of steroids, mycophenolate, and calcineurin inhibitors. Induction therapy was 20 mg basiliximab (Simulect) on day 0 and day 4. Antithymocyte globulin (2 mg/kg) was used in steroid-resistant acute rejection cases. Results: There were 13 surgical complications (14.1%) after 92 consecutive deceased donor renal transplants, and 4 of these were classified as miscellaneous surgical complications. Four of 9 cases were early, and the rest were classified as late complications. Postoperative early complications were bleeding (n = 2), urine leak (n = 1), and renal artery thrombosis (n = 1). Lymphoceles (n = 4) and urine leak (n = 1) occurred as late complications. Postoperative median follow-up was 78 months, during which 11 grafts (12%) were lost and 7 patients (7.6%) died from sepsis (n = 4), myocardial infarction, aortic dissection, and fungal pneumonia. No patients died from any surgical complications. The 1-year, 5-year, and 10-year survival rates of patients were 98%, 94%, and 94% and for grafts were 97%, 94%, and 88%, respectively. Conclusion: Despite the limited number of deceased donor organs, improvements of surgical techniques at our center have facilitated success with deceased donor renal transplant at rates similar to other successful centers in the world.