Surgically treated early complications after kidney transplantation.
Early surgical complications after kidney transplantation (KTx) remain important clinical problems. The 35 patients in whom forty-six complications appeared within 1 month required surgical treatment. The causes were divided into four groups: bleeding and/or hematoma of the perigraft region (n = 22); urological complications (n = 9); simultaneous bleeding and/or hematoma and urological complications (n = 6); and others (n = 9). Among the 28 cases of hemorrhagic complication, the source of bleeding was not localized during the reoperation in 53.7% cases. Vascular anastomotic leakage was confirmed only in 7.1% of patients. The most common urological complications were stricture of (46.7% cases) and leakage at (26.7%) the vesicoureteral anastomosis. Within 3 months after KTx nephrectomy was performed in 27.5% of patients who had been previously operated for surgical complications compared to 4.6% patients without interventions. Among patients with a single reoperation the graft had to be removed in 20.0% compared with 44.4% for those with multiple reoperations. Localization of the bleeding source causing an early perigraft hematoma is not always possible. The most common early urological complication is a vesicoureteral stricture caused by edema. Surgical complications that appear within 1 month after KTx increase the risk of early graft loss.
Król
R
R
Department of General and Transplant Surgery, Silesian University of Medicine, Katowice, Poland. robertk@hot.pl
Cierpka
L
L
Ziaja
J
J
Pawlicki
J
J
Budziński
G
G
D000293:Adolescent; D000328:Adult; D005260:Female; D006406:Hematoma / Q000601:surgery; D006470:Hemorrhage / Q000601:surgery; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies