03 December 2019 : Original article
An Update on Early Urological Complications in Kidney Transplantation: A National Cohort Study
Moira H.D. Bruintjes12ABCDEF*, Frank C.H. d’Ancona2ACDE, Xiaoye Zhu2CDE, Andries J. Hoitsma3ABDE, Michiel C. Warlé1ABCDEDOI: 10.12659/AOT.920086
Ann Transplant 2019; 24:617-624
Abstract
BACKGROUND: This study aimed to provide an update on the occurrence of early urological complications in living-donor and deceased-donor kidney transplantation (KTX).
MATERIAL AND METHODS: Data on all kidney transplant recipients in the Netherlands between January 2005 and December 2015 were retrieved from the prospectively collected Dutch National Organ Transplant Registry Database (NOTR). We assessed the incidence of major urological complications (MUCs) within 3 months after KTX, defined as urinary leakage and ureteral obstruction. Outcomes of living donor and deceased donor kidney transplants were compared. We performed regression analysis to identify predictive factors of urological complications and studied the influence of early urological complications on graft and patient survival. We performed an additional sub-study to explore the influence of preservation of the peri-ureteric connective tissue in living-donor KTX on the occurrence of urological complications.
RESULTS: Among 3329 kidney transplant recipients, urological complications occurred in 208 patients (6.2%) within 3 months after surgery. There were no significant differences in complication rates between recipients from living donors and deceased donors. Multiple regression analysis showed that older donor age and previous cardiac events of the recipient were predictors for the development of urological complications. Graft and patient survival were not affected by early MUCs. The additional sub-study showed that preservation of peri-ureteric tissue within living-donor KTX was not independently associated with urological complications.
CONCLUSIONS: Many living- and deceased-donor KTX recipients have early urological complications. MUCs did not affect long-term graft or patient survival.
Keywords: Anastomotic Leak, Kidney Transplantation, Postoperative Complications, Ureteral Obstruction, Aged, Cohort Studies, Graft Survival, Incidence, Kaplan-Meier Estimate, Living Donors, Middle Aged, Netherlands, Prospective Studies, Registries, Risk Factors, Urinary Incontinence
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