title: [Postoperative complications following kidney transplantation].
abstract: Despite the remarkable development of kidney transplantation techniques, surgical complications are still a very important factor affecting the final outcome of kidney transplantation. After 92 kidney transplantations (22 from cadaver donors and 70 from living donors) performed at Skopje hospital (Macedonia), we observed the following complications: nine (10%) urinary fistula, five (5%) graft ruptures, seven (8%) lymphoceles, two (2%) urinary calculosis, two (2%) intestinal perforations, four (4%) renal artery stenoses, one (1%) renal artery thrombosis, and seven (8%) early complications following surgical incision. Complications were detected by either ultrasonography, intravenous pyelography, percutaneous nephrostomy with anterograde pyelography, computerized tomography, and intravenous digital angiography. They were subsequently treated by application of modern surgical procedures: use of the ureter (termino-terminal or uretero-pyelic anastomosis) for treatment of urinary fistulas; conservative surgery using tissue glue and external compression with polyglactin 910 (Vicryl) mesh for graft ruptures; drainage and application of sclerosants under ultrasound control and intraperitoneal marsupialization for the clinically relevant lymphoceles; transluminal angioplasty with balloon dilatation in case of significant arterial stenosis; extracorporeal shock wave lithotripsy and surgery for urinary calculi. Intestinal perforations and problems relating to parietal tissue were quickly solved using standard surgical techniques. On total, rejection of the graft occurred in four (4%) cases following surgical complications, while one death was encountered due to septic peritonitis. We consider the percentage of surgical complications acceptable, as this work consists of a pioneering effort in this Balkan region.
authors.affiliation: Centre hospitalier universitaire Skopje, clinique d'urologie, centre de transplantation rénale, Skopje, République de Macédoine.
authors.forename: Z
authors.initials: Z
authors.lastname: Popov
authors.forename: N
authors.initials: N
authors.lastname: Ivanovski
authors.forename: L
authors.initials: L
authors.lastname: Lekovski
authors.forename: O
authors.initials: O
authors.lastname: Stankov
authors.forename: S
authors.initials: S
authors.lastname: Dohcev
authors.forename: D
authors.initials: D
authors.lastname: Petrovski
authors.forename: K
authors.initials: K
authors.lastname: Cakalaroski
authors.forename: J
authors.initials: J
authors.lastname: Janculev
authors.forename: P
authors.initials: P
authors.lastname: Kolevski
authors.forename: C C
authors.initials: CC
authors.lastname: Abbou
authors.forename: D
authors.initials: D
authors.lastname: Chopin
mesh_terms: D000328:Adult; D000368:Aged; D002102:Cadaver; D002114:Calcinosis / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D015994:Incidence; D007416:Intestinal Perforation / Q000188:drug therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D051437:Renal Insufficiency / Q000628:therapy; D018843:Republic of North Macedonia / Q000453:epidemiology; D012307:Risk Factors; D018805:Sepsis