title: Independent risk factors for urological complications after deceased donor kidney transplantation.
abstract: Urological complications after kidney transplantation are mostly related to the ureteroneocystostomy, often requiring interventions with additional costs, morbidity and mortality. Our aim was to assess risk factors for urological complications in deceased donor kidney transplantation. Between January 2000 and December 2011, 566 kidney transplantations were performed with deceased donor kidneys. Recipients were divided in a group with, and a group without urological complications, defined as the need for a percutaneous nephrostomy catheter or surgical revision of the ureteroneocystostomy. Univariate and multivariate analyses were performed. Univariate analysis showed increased number of male donors (p = 0.041), male recipients (p = 0.002), pre-emptively transplanted recipients (p = 0.007), and arterial reconstructions (p = 0.004) in the group with urological complications. Less urological complications occurred in recipients on hemodialysis (p = 0.005). More overall surgical interventions (p<0.001), surgical site infections (p = 0.042), urinary tract infections (p<0.001) and lymphoceles (p<0.001) occurred in the group with urological complications. Multivariate analysis showed that male recipients (p = 0.010) and arterial reconstructions (p = 0.019) were independent risk factors. No difference was found between both groups in patient or graft survival. In conclusion, recipient male gender and arterial reconstruction are independent risk factors for urological complications after deceased donor kidney transplantation. Nevertheless, graft and recipient survival is not different between both groups.
authors.affiliation: Department of Surgery, Division of Transplant Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Inez K B
authors.initials: IK
authors.lastname: Slagt
authors.affiliation: Department of Surgery, Division of Transplant Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Jan N M
authors.initials: JN
authors.lastname: Ijzermans
authors.affiliation: Department of Surgery, Division of Transplant Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Laurents J
authors.initials: LJ
authors.lastname: Visser
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Joke I
authors.initials: JI
authors.lastname: Roodnat
authors.affiliation: Department of Surgery, Division of Transplant Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: Türkan
authors.initials: T
authors.lastname: Terkivatan
mesh_terms: D003643:Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D014019:Tissue Donors; D014570:Urologic Diseases / Q000209:etiology*