title: Risk factors for surgical complications after renal transplantation and impact on patient and graft survival.
abstract: OBJECTIVE
  We report herein the incidence of and factors predisposive to surgical complications (SC) after renal transplantation.
  
  
  METHODS
  Between 2004 and 2008, we performed 200 renal transplantation. We retrospectively studied recipient and donor characteristics, cold ischemia time, surgical revision in the month after transplantation, delayed graft function, surgical complications (vascular, urologic, wound, or bleeding), as well as graft and patient 5-year survival rates.
  
  
  RESULTS
  Sixty-six surgical complications were reported among 49 patients with a preponderance of urologic complications. We noted 6.1% Clavien I, 1.5% Clavien II, 30.3% Clavien IIIa, 53% Clavien IIIb, and 9.1% Clavien IVa SCs. Vascular complications showed a worse prognosis. Among recipients, dialysis duration before transplantation (40.3 ± 50.8 months in SCs versus 28 ± 26.5 months in the control unaffected group, P = .032) and anti-HLA immunization (34.7 ± 48% versus 21.2 ± 41%, P = .05) appeared to be risk factor. No significant factor was identified among donors, although patients with surgical complications received older transplants than the control popuation (49.7 ± 14.5 years versus 45.5 ± 15.1 years, P = .08). A greater percentage of delayed graft function (30.6 ± 46.6% versus 11.4 ± 31.9%; P = .001) and graft rejection episodes (34.7 ± 48.1% versus 17.9 ± 38.4%, P .013) were observed among the SC compared with the control group. No significant difference in patient (89.5% versus 95.6% confidence interval, CI 95% [0.7-10.0]; P = .14) or graft survival (88.7% versus 91.8%, CI 95% [0.4-3.9] P = .63) was observed between the groups.
  
  
  CONCLUSIONS
  Surgical complications, especially urologic complications appear frequently after renal transplantation. Dialysis duration and pre-transplant immunization were linked to the occurrence of a surgical complication, which did not affect graft or patient survival.
authors.affiliation: Department of Urology and Renal Transplantation, University Hospital Saint-Jacques, Besancon, France.
authors.forename: P
authors.initials: P
authors.lastname: Pillot
authors.forename: N
authors.initials: N
authors.lastname: Bardonnaud
authors.forename: J
authors.initials: J
authors.lastname: Lillaz
authors.forename: G
authors.initials: G
authors.lastname: Delorme
authors.forename: E
authors.initials: E
authors.lastname: Chabannes
authors.forename: S
authors.initials: S
authors.lastname: Bernardini
authors.forename: G
authors.initials: G
authors.lastname: Guichard
authors.forename: H
authors.initials: H
authors.lastname: Bittard
authors.forename: F
authors.initials: F
authors.lastname: Kleinclauss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D051799:Delayed Graft Function / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D015994:Incidence; D007518:Isoantibodies / Q000097:blood; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000276:immunology / Q000401:mortality; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000453:epidemiology; D014652:Vascular Diseases / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies