Urological and Surgical Complications in 362 Consecutive Living Related Donor Kidney Transplantations

Abstract

Objective: The aim of this study is to review retrospectively the surgical and urological complications encountered in 362 cases of living related donor kidney transplantations (LRDTs). Material and Methods: Between 1983 and 2002, 362 consecutive LRDTs were performed at our institution. The urological and surgical complications were determined in these cases. Results: Overall, urological and surgical complications were encountered in 57 (15.7%) of the renal transplants. Of the 362 patients, urological complications were detected in 29 of them (8.01%), including 5 urinary fistula (with 1 distal ureteral necrosis), 2 ureteric stenosis, 1 renal calculi, 8 symptomatic vesicoureteral reflux and 13 lymphocele requiring intervention. Vascular complications were developed in 5 patients such as renal vein thrombus in 1 and renal arterial stenosis in 4 cases. Wound infection was detected in 6 patients. Fourteen patients underwent surgical explorations due to perinephric hematoma during the early postoperative period. Renal allograft rupture due to accelerated rejection was developed in 2 cases. A lower segmental arterial injury occurred in 1 patient during the operation. Conclusion: LRDT is an important treatment alternative for patients with end-stage renal disease. Many complications may occur after renal transplantations. Our rate of complications is within the range of the current literature. After a modification of our surgical technique, as not dissecting the external iliac artery, the number of lymphoceles has decreased dramatically and with using ureteric stents, we detected a significant decrease in urinary complication rates.

Chirurginės komplikacijos po inkstų transplantacijos

“…Tokių komplikacijų gydymas kainuoja, padidėja pacientų sergamumas ir mirtingumas, didėja inksto transplantato praradimo rizika [11]. Ankstyvos kraujagyslių anastomozių komplikacijos [7], literatūros duomenimis, pasitaiko apie 10 proc. [12,13], tačiau pasekmės transplantatui labai rimtos: kraujagyslių trombozė su transplantato pašalinimu arba net transplantato plyšimas su ūmiu kraujavimu [14].…”

Complicaciones quirúrgicas en el trasplante renal y su influencia en la supervivencia del injerto

“…Las complicaciones arteriales son má s frecuentes que las venosas 2,8,9 . La má s comú n es la estenosis de la arteria renal con una incidencia del 1-23% [10][11][12][13] .…”

Complications of Renal Transplantation

“…Currently, patients who undergo ureteroneocystostomy have a lower incidence of urologic complications (1%-8%) with very low patient mortality. 4,5 Urine Leaks and Urinomas Urine leaks manifest in the early postoperative period with pain, swelling, and discharge from the wound. Extravasation of urine may occur from the renal pelvis, ureter, or ureteroneocystostomy site.…”