title: Impact of surgeon experience on complication rates and functional outcomes of 484 deceased donor renal transplants: a single-centre retrospective study.
abstract: OBJECTIVE
  To determine how postoperative and functional outcomes after deceased donor renal transplantation (DDRT) are related to surgeon experience.
  
  
  METHODS
  The outcomes of 484 adult DDRT performed by 13 urological surgeons were retrospectively reviewed. After completion of a staged renal transplant training programme under supervision of an attending urological transplant surgeon, the 13 surgeons were either assigned to the inexperienced group (n = 8) or the experienced group (n = 5). Surgeons in the experienced group had performed more than 30 unsupervised DDRT in a standard fashion with routine ureteric stenting. Between 1988 and 2005, inexperienced surgeons performed 152 DDRT, whereas experienced surgeons performed 332 DDRT.
  
  
  RESULTS
  Patient and graft survival at 2 hyears were 98% and 94.7%, respectively. Early graft loss in five recipients was unrelated to surgeon experience. Delayed graft function occurred in 29% of cases and median 1-year serum-creatinine was 1.48 mg/dL, with no difference between surgeon groups. Postoperative bleeding and lymphocele formation were the most frequent surgical complications, with an equal distribution between groups. Ureteric complications had a significantly higher incidence among inexperienced surgeons (6.6% versus 2.7%; P = 0.04).
  
  
  CONCLUSIONS
  We conclude that DDRT as performed by inexperienced urological renal transplant surgeons has both acceptable short- and long-term outcomes.
authors.affiliation: Department of Urology, Charité University Medicine Berlin, Campus Mitte, Berlin, Germany.
authors.forename: Hannes
authors.initials: H
authors.lastname: Cash
authors.forename: Torsten
authors.initials: T
authors.lastname: Slowinski
authors.forename: Anette
authors.initials: A
authors.lastname: Buechler
authors.forename: Annaeva
authors.initials: A
authors.lastname: Grimm
authors.forename: Frank
authors.initials: F
authors.lastname: Friedersdorff
authors.forename: Danilo
authors.initials: D
authors.lastname: Schmidt
authors.forename: Kurt
authors.initials: K
authors.lastname: Miller
authors.forename: Markus
authors.initials: M
authors.lastname: Giessing
authors.forename: T Florian
authors.initials: TF
authors.lastname: Fuller
mesh_terms: D002102:Cadaver; D002983:Clinical Competence; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology* / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome