Increased risk of postoperative in‐hospital complications after radical prostatectomy in patients with prior organ transplant

Abstract

Background:To analyze postoperative, in-hospital, complication rates in patients with organ transplantation before radical prostatectomy (RP).Methods: From National Inpatient Sample (NIS) database (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) prostate cancer patients treated with RP were abstracted and stratified according to prior organ transplant versus nontransplant. Multivariable logistic regression models predicted in-hospital complications.Results: Of all eligible 202,419 RP patients, 216 (0.1%) underwent RP after prior organ transplantation. Transplant RP patients exhibited higher proportions of Charlson comorbidity index ≥2 (13.0% vs. 3.0%), obesity (9.3% vs. 5.6%, both p < 0.05), versus to nontransplant RP. Of transplant RP patients, 96 underwent kidney (44.4%), 44 heart (20.4%), 40 liver (18.5%), 30 (13.9%) bone marrow, <11 lung (<5%), and <11 pancreatic (<5%) transplantation before RP. Within transplant RP patients, rates of lymph node dissection ranged from 37.5% (kidney transplant) to 60.0% (bone marrow transplant, p < 0.01) versus 51% in nontransplant patients.Regarding in-hospital complications, transplant patients more frequently exhibited, diabetic (31.5% vs. 11.6%, p < 0.001), major (7.9% vs. 2.9%) cardiac complications (3.2% vs. 1.2%, p = 0.01), and acute kidney failure (5.1% vs. 0.9%, p < 0.001), versus nontransplant RP. In multivariable logistic regression models, transplant RP patients were at higher risk of acute kidney failure (odds ratio [OR]: 4.83), diabetic (OR: 2.81), major (OR: 2.39), intraoperative (OR: 2.38), cardiac (OR: 2.16), transfusion (OR: 1.37), and overall complications (1.36, all p < 0.001). No in-hospital mortalities were recorded in transplant patients after RP.Conclusions: Of all transplants before RP, kidney ranks first. RP patients with prior transplantation have an increased risk of in-hospital complications. The highest risk, relative to nontransplant RP patients appears to acute kidney failure.

Correlation Analysis of Postoperative Recurrence and Metastasis of Renal Cancer with Type 2 Diabetes Mellitus

“…Smoking has now become one of the main risk factors threatening the incidence of Chinese population and it is the main cause of cardiovascular disease, cancer and other diseases and the death of patients with various diseases. The number of smokers in my country accounts for 30 % of the total number of smokers in the world, which makes the disease burden caused by smoking very serious; a survey study found that smoking ranks second among 87 causes of death, second only to high blood pressure [17] . Smoking was a risk factor for postoperative recurrence and metastasis.…”