title: Living-donor and Deceased-donor Renal Transplantation: Differences in Early Outcome--A Single-center Experience.
abstract: Living-donor renal transplant (LDRT) yields better long-term outcomes than cadaver-donor renal transplant (CDRT). The aim of the present study was to identify the differences in the early postoperative period between LDRT and CDRT recipients. A retrospective study was conducted including all patients receiving a LDRT and CDRT in this center in 2012 and 2013. A total of 153 recipients were identified (CDRT n = 113, LDRT n = 40). On average, LDRT recipients were younger by 12.7 years (P < .001) and had fewer comorbidities (P < .05). There were no differences in gender or primary kidney disease. Mean time on dialysis, dialytic technique, and ischemia time were different between groups (P < .001, P < .01, P < .001, respectively). On average the length of hospital stay for LDRT recipients was 7 days shorter (P < .001). We found significant differences in the occurrence of early complications (P < .001) and its subtypes, with the exception of neurologic and respiratory complications. There were no differences in reinterventions and readmissions between groups. Recipients' age was an independent risk factor for overall postoperative complications and infectious complications; hypertension before renal transplant and cold ischemia time were predictors for cardiovascular complications; and cold ischemia time also was a predictor of nephrourologic and endocrine complications. CDRT patients had more postoperative complications during hospital stay. The variables identified as predictors of early outcome were different for the 2 groups of patients. Modifiable risk factors for better early outcomes and the impact of immediate complications in long-term graft survival must be investigated.
authors.affiliation: Centro Hospitalar do Porto, Anesthesiology/Intensive Care/Emergency Department, Porto, Portugal. Electronic address: joanaguimaraes@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Guimarães
authors.affiliation: Centro Hospitalar do Porto, Anesthesiology/Intensive Care/Emergency Department, Porto, Portugal.
authors.forename: A M
authors.initials: AM
authors.lastname: Araújo
authors.affiliation: Centro Hospitalar do Porto, Anesthesiology/Intensive Care/Emergency Department, Porto, Portugal.
authors.forename: F
authors.initials: F
authors.lastname: Santos
authors.affiliation: Centro Hospitalar do Porto, Anesthesiology/Intensive Care/Emergency Department, Porto, Portugal; Universidade Aberta, Department of Sciences and Technology, Del. Porto, Porto, Portugal.
authors.forename: C S
authors.initials: CS
authors.lastname: Nunes
authors.affiliation: Centro Hospitalar do Porto, Anesthesiology/Intensive Care/Emergency Department, Porto, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Casal
mesh_terms: D000328:Adult; D002102:Cadaver; D015331:Cohort Studies; D050377:Cold Ischemia; D005260:Female; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011174:Portugal; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D052096:Warm Ischemia