Post–Kidney Transplant Surgical Complications Under New Immunosuppressive Regimens

Post-renal transplant surgical complications with newer immunosuppressive drugs: mycophenolate mofetil vs. m-TOR inhibitors

“…Troppmann et al reported 53 and 7% of wound complications with and without sirolimus in the immunosuppressive regimen, respectively [12]. Similarly in a recent study by Burgos et al, it was noted that wound-healing problems occurred more frequently in patients receiving mTORI (8.0% compared to 4.3% without mTORI) [13]. Wound healing relies on specific growth factors to promote cellular proliferation and angiogenesis.…”

“…Lymphoceles are the most frequently noted fluid collections after renal transplantation with a reported incidence of between 18 and 51% of cases [16]. Burgos et al reported that the incidence of lymphoceles was significantly higher in regimens with than without mTOR inhibitors: 16 versus 3.7% and the incidence was not influenced by the use of MMF [13]. In a retrospective matched pair comparative study, Valente et al reported symptomatic lymphocele formation occurred in 2.3% of MMF-treated patients compared to 9.5% of those treated with sirolimus.…”

Pre‐transplant dialysis modality does not influence short‐ or long‐term outcome in kidney transplant recipients: analysis of paired kidneys from the same deceased donor

“…Lymphocele—a collection of lymph fluid in a cavity that is not covered by an epithelial membrane—occurs in 0.6% to 49% of KT recipients, mainly due to the surgical injury to the iliac or renal hilar lymphatic vessels. Differences in diagnostic criteria underlie the broad variability in the reporting frequency of this complication across different series . A higher incidence of lymphocele and peri‐graft fluid collection has been correlated by some authors with the presence of acute graft rejection and obesity and with the type of immunosuppression used, mainly those including mTOR inhibitors .…”

“…Differences in diagnostic criteria underlie the broad variability in the reporting frequency of this complication across different series . A higher incidence of lymphocele and peri‐graft fluid collection has been correlated by some authors with the presence of acute graft rejection and obesity and with the type of immunosuppression used, mainly those including mTOR inhibitors . Two studies have evaluated the occurrence of lymphocele after KT according to the pre‐transplant dialysis modality, with conflicting results .…”

Effects of immunosuppressive therapy on wound healing

“…Three‐hundred and fifty‐nine cadaveric transplants were retrospectively evaluated for the incidence of various surgical complications which included impaired wound healing. This study found that the incidence of wound‐healing complications in the transplant patients was not significant (30). This study included the use of different immunosuppressive regimens, but unfortunately, some of the regimens were not as frequently used compared with others.…”