Abstract
Background: End Stage Renal Disease (ESRD) requires renal replacement therapy such as hemodialysis and peritoneal dialysis or Kidney transplantation (KTR) for the patient to survive. The purpose of renal replacement therapy is to prolong and maintain the quality of life. The treatment which allows the longest extension of useful life is chosen for a patient. The history of renal transplantation illustrates the successful integration of the fields of surgery, medicine and immunology, reflecting the development of healthcare in modern era which has improved the quality of life of the transplant patients.1
Low survival rates and a relatively poor quality of life on hemodialysis make kidney transplantation an attractive treatment alternative with good clinical results even in elderly patients with comorbidities
Objectives: 1. To analyse early surgical complications in renal transplant recipients following deceased donor and live donor (ABO compatible or incompatible) kidney transplants and compare it with the contemporary literature.
- To identify risk factors related to recipient characteristics associated with surgical complications.
- To find possible methods to prevent surgical complications.
Methods: After standard evaluation and following strict protocols, patient undergoing Transplant was closely followed to diagnose any complication at the earliest and treat at the very behest. This is a prospective study with main focus to assess surgical complications and overall outcome
Conclusions: Total number of surgical complications observed was 44. However total number of patients having surgical complications was 35 (33.9%). 9 (8.7%) patients had multiple complications while 26 (25.2%) patients developed single surgical complication.
Urological complication was seen in 25 (24.3%) patients and they constituted 59% of all surgical complications. Urinary Tract Infection was seen in 24 patients (23.3%).
No patient had ureteric leak at our centre. Ureteric stenosis was seen in 2 (1.94%) patients, lesser than that in literature, may be attributed to refined surgical skills.
References
- Risaliti A; Surgical complications after kidney transplantation; G ItalNefrol.2004 Jan-Feb;21Suppl 26:S43-7.
- Roodnat JI, Zietse R, Mulder PG et al. The vanishing importance of age in renal transplantation. Transplantation 1999; 67: 576–580.
- Humar A, Matas AJ. Surgical complications after kidney transplantation. Semin Dial 2005; 18: 505–510.
- Herna´ ndez D, Rufino M, Bartolomei S et al. Clinical impact of preexisting vascular calcifications on mortality after renal transplantation. Kidney Int 2005; 67:2015–2020.
- Aneesh Srivastava. Renal transplantation: An update. Indian J Urol. 2007 Jul-Sep; 23(3): 270-271.
- http://www.livemint.com/2009/02/20002008/India-ranks-2nd-in-kidney-tran.html.
- John Maynard Barry, Michael Joseph Conlin. Renal Transplantation In Campbell-Walsh Urology, 10th edition editors- Alan J. Wein, Louis R. Kavoussi Saunders,2011. pages 1226-1253.
- Acharya VN. Status of renal transplant in India--May 1994. J Postgrad Med [serial online] 1994 [cited 2012 May 26];40:158.
- David Hamilton. Kidney transplantation: a history, in Kidney Transplantation: Principles and Practice, Sixth Edition. Editors Peter J. Morris, and Stuart J. Knechtle, Saunders, Elsevier,2008 pages 1-7.
- Kekre SN., Renal transplantation: challenges ahead.Indian J Urol.20072007 Jul-Sep; 23(3): 223.
- Clavien PA, et al. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111:518, 1992.
- Hernandez D, Rufino M, Armas S et al.; Retrospective analysis of surgical complications following cadaveric kidney transplantation in the modern transplant era; Nephrol Dial Transplant (2006) 21: 2908–2915.
- Benedetti E, Hakin N, Perez E, Matas A. Current topics in medicine: renal transplantation. Acad Radiol 1995; 2:159–199.
- Karam G, Maillet F, Parant S et al. Ureteral necrosis after kidney transplantation: risk factors and impact on graft and patient survival. Transplantation 2004; 78: 725–729.
- Maier U, Madersbacher S, Banyai-Falger S et al. Late ureteral obstruction after kidney transplantation. Fibrotic answer to previous rejection? TransplInt 1997; 10: 65–68.
- Mundy AR, Podesta ML, Bewick M, Rudge CJ, Ellis FG. The urologic complications of 1000 renal transplants.Br J Urol 1981; 53:397–402.
- Soltes GD, Rainwater JR, Middlebrook MR, et al. Interventional uroradiology. World J Urol 1998; 16:52–61.
- Fayek SA, Keenan J, Haririan A, Cooper M, Barth RN, Schweitzer E, Bromberg JS, Bartlett ST, Philosophe B. Ureteral stents are associated with reduced risk of ureteral complications after kidney transplantation: a large single center experience. Transplantation. 2012 Feb 15;93(3):304-8.
Corresponding Author
Dr Sankelp Joshi
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.200
