title: [Surgical complications of renal transplantation].
abstract: OBJECTIVE
  To report the nature, incidence, diagnosis and treatment options of surgical complications after renal transplantation.
  
  
  METHODS
  Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov/) and Embase (http://www.embase.com/) database from 1960 to 2016 using the following keywords "fistula; lymphocele; stricture; thrombosis", in association with "renal transplantation" in Title/Abstract field. Articles were selected according to methods, language of publication and relevance. A total of 7618 articles were identified including specifically 981 for vascular complications, 1016 for urologic complications and 239 for lymphocele; after careful selection 190 publications were eligible for our review.
  
  
  RESULTS
  Surgical complications occur in 1 to 30% of renal transplantations while being incompletely reported without consensual management. Angioplasty techniques led to a significant improvement of short- and long-term vascular complications outcome. Risk factors for transplant thrombosis are a right allotransplant, multiple renal arteries or vasculopathy in the donor, diabetes, arterial disease or thrombophilia in the recipient and hemodynamic changes during procedure. Urinary complications and lymphocele significantly impair overall outcome and recipients quality of life with no demonstrated impact on allotransplant survival. Immediate or salvage pelvi-ureterostomy is a main treatment option for ureteral strictures and fistula.
  
  
  CONCLUSIONS
  Prevention of surgical complications following renal transplantation relies on careful allotransplant preparation and strict respect of surgical best practices. Increasing comorbidities in recipients as well as marginal donors are significant limits for the improvement of post-transplant surgical outcome.
authors.affiliation: Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France. Electronic address: marc-olivier.timsit@egp.aphp.fr.
authors.forename: M-O
authors.initials: MO
authors.lastname: Timsit
authors.affiliation: Service d'urologie et transplantation rénale, CHRU de Besançon, 25000 Besançon, France; Université de Franche-Comté, 25000 Besançon, France; Inserm UMR 1098, 25000 Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Kleinclauss
authors.affiliation: Service d'urologie et transplantation rénale, CHRU de Besançon, 25000 Besançon, France; Université de Franche-Comté, 25000 Besançon, France.
authors.forename: V
authors.initials: V
authors.lastname: Richard
authors.affiliation: Service d'urologie et transplantation rénale, CHU de Montpellier, 34090 Montpellier, France; Université de Montpellier, 34090 Montpellier, France.
authors.forename: R
authors.initials: R
authors.lastname: Thuret
mesh_terms: D003663:Decision Trees; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008210:Lymphocele / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014019:Tissue Donors; D014570:Urologic Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
keywords: Complications chirurgicales; Fistula; Fistule; Lymphocele; Lymphocèle; Renal transplantation; Stricture; Sténose; Surgical complications; Thrombose; Thrombosis; Transplantation rénale