Influence of Long-Term Dialysis Treatment on Operative Complications After Renal Transplantation

Mokos, Ivica; Bašić‐Jukić, Nikolina; Kaštelan, Željko; Kes, Petar; Pasini, Josip

doi:10.1016/j.transproceed.2010.04.061

Cited by 12 publications

(6 citation statements)

References 5 publications

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“…Moreover, longer periods of dialysis may further contribute to chronic inflammatory states as longer periods of dialysis had been shown to upregulate inflammatory markers such as IL‐6 and CRP . This is also consistent with the findings of Mokos et al that showed higher likelihood of lymphoceles following kidney transplant for patients with longer duration of hemodialysis. Nonetheless, the rates of symptomatic lymphoceles were low in both pre‐emptive and post‐dialysis populations in DD and LD groups.…”

Section: Discussionsupporting

confidence: 88%

Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Kim

Lorenzo

Farhat

et al. 2018

Clinical Transplantation

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Purpose To determine whether there is a benefit to pre‐emptive kidney transplantation in reducing surgical complications in pediatric population. Methods A retrospective review of kidney transplantations in our institution from 2000 to 2015 was performed. Intra‐ and postoperative complication rates and one‐year graft survival were compared in their respective donor type groups (pre‐emptive DD vs post‐dialysis DD; pre‐emptive LD vs post‐dialysis LD). Results A total of 318 patients were identified (pre‐emptive DD, n = 21; post‐dialysis DD, n = 145; pre‐emptive LD, n = 54; post‐dialysis LD, n = 98). Between the DD groups, post‐dialysis DD group was more likely to be female (P = 0.017). There was no difference in rates of intraoperative complications or graft loss (P = 0.365 and 1.000, respectively). Post‐dialysis DD groups were more likely to have postoperative complications (9.5% vs 35.1%, P = 0.023), but no difference in complications with Clavien‐Dindo grade 3 or higher was found (P = 0.130). Between the LD groups, post‐dialysis LD group was more likely to be females (P = 0.017) and with intrinsic renal (non‐urological/structural) ESRD etiology (P = 0.003). There was no difference in rates of intra‐and postoperative complications or graft loss (P = 0.353, P = 0.605, and P = 0.616, respectively). Conclusions Overall, there are similar perioperative complication rates between pediatric pre‐emptive and post–dialysis kidney transplant recipients.

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Section: Discussionsupporting

confidence: 88%

Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Kim

Lorenzo

Farhat

et al. 2018

Clinical Transplantation

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“…The anticoagulation therapy together with the defective coagulation associated with uraemia may impair the sealing of lymph vessels in the wound [ 23 , 24 ]. Obesity of the recipients with a body mass index >24 kg/m 2 [ 8 , 25 , 26 ], recipient age [ 27 ], acute tubular necrosis-delay graft function [ 15 ], warm ischaemia time [ 27 ], duration of dialysis treatment [ 28 ] and retransplantation [ 29 ] have been also associated with a greater risk of lymphocele. It is also known that some immunosuppressive drugs such as rabbit antithymocyte globulin, high dose of mycophenolate mofetil (MMF) (>2 g/day) and steroids increase the risk of lymphatic complications [ 15 , 27 , 30 – 33 ].…”

Section: Introductionmentioning

confidence: 99%

Lymphatic disorders after renal transplantation: new insights for an old complication

Ranghino¹,

Segoloni²,

Lasaponara

et al. 2015

Clin Kidney J

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In renal transplanted patients, lymphoceles and lymphorrhea are well-known lymphatic complications. Surgical damage of the lymphatics of the graft during the procurement and of the lymphatic around the iliac vessels of the recipients has been associated with development of lymphatic complications. However, lymphatic complications may be related to medical factors such as diabetes, obesity, blood coagulation abnormalities, anticoagulation prophylaxis, high dose of diuretics, delay in graft function and immunosuppressive drugs. Consistently, immunosuppression regimens based on the use of mTOR inhibitors, especially in association with steroids and immediately after transplantation, has been associated with a high risk to develop lymphocele or lymphorrhea. In addition, several studies have demonstrated the association between rejection episodes and lymphatic complications. However, before the discovery of reliable markers of lymphatic vessels, the pathogenic mechanisms underlining the development of lymphatic complications during rejection and the influence of mTOR inhibitors remained not fully understood. The recent findings on the lymphatic systems of either native or transplanted kidneys together with the advances achieved on lymphangiogenesis shared some lights on the pathogenesis of lymphatic complications after renal transplantation. In this review, we describe the surgical and medical causes of lymphatic complications focusing on the rejection and immunosuppressive drugs as causes of lymphatic complications.

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“…It is also well known that the duration of dialysis treatment is a significant factor for surgical complications. The vascular arteriosclerosis is an important factor affecting the frequency of bleeding and lymphocele formation . Fortunately in this research, the outcome of renal transplantation of the long‐term dialysis patient group was equivalent to that of the short‐term dialysis patient group.…”

Section: Discussionmentioning

confidence: 61%

Influence of Dialysis Duration on the Outcome of Living Kidney Transplantation

et al. 2014

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Previous studies have reported negative impacts of long-term dialysis on kidney transplantation (KTx) outcomes. However, advances in surgical techniques, immunosuppressive therapies, and post-transplant monitoring have led to an impressive increase in patient and allograft survival. Thus, the number of KTx among patients on long-term dialysis is increasing. We evaluated the influence of dialysis duration on the outcome of living donor KTx. Between January 2000 and October 2011, we performed 1098 first KTx from living donors in adults (>18 years). We divided the patients into six groups, A group: pre-emptive kidney transplantation, B group: <24 months duration of dialysis, C group: 25-60 months duration, D group: 61-120 months duration, E group: 121-240 months duration, and F group: ≥ 241 months duration. The 5-year patient survival rates were 95.7, 98.8, 99.0, 99.0, 97.3, and 100% in groups A-F, respectively. The 5-year graft survival rates were 91.3, 95.6, 94.2, 96.3, 90.7, and 100% in groups A-F, respectively. No significant differences were observed in patient or graft survival among the six groups. Longer dialysis duration was correlated with lower rates of preoperative hypertension and diabetes mellitus. Survivors of long-term dialysis tended to be in good compliance with self-management. If recipients of living KTx have few complications, good prognoses are expectable even if dialysis periods are very long.

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Influence of Long-Term Dialysis Treatment on Operative Complications After Renal Transplantation

Cited by 12 publications

References 5 publications

Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Lymphatic disorders after renal transplantation: new insights for an old complication

Influence of Dialysis Duration on the Outcome of Living Kidney Transplantation

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