An updated analysis of the surgical andurological complications of 789 living related donor kidney transplantations: Experience of a single center

Abstract

An updated analysis of the surgical and urological complications of 789 living-related donor kidney transplantations: Experience of a single centerTayfun Oktar,Taner Koçak,Tzevat Tefik,Selçuk Erdem,Öner Şanlı,H. Orhan Ziyla,İsmet NaneDepartment of Urology, İstanbul University İstanbul Faculty of Medicine, İstanbul-TurkeyBACKGROUND: This study aims to review retrospectively the surgical and urological complications encountered in 789 cases of living-related donor kidney transplantations (LRDKTs).METHODS: In this study, the clinical records of 789 LRDKTs, which were performed between 1983 and 2017, were reviewed retrospectively concerning surgical and urological complications.RESULTS: Overall, urological and surgical complications were encountered in 87 (11.02%) of the cases. Of the 789 patients, urological complications were detected in 44 of them (5.6%), including 8 urinary fistula (with 1 distal ureteral necrosis), 10 ureteric stenosis, 1 renal calculus, 9 symptomatic vesicoureteral reflux and 16 lymphoceles requiring intervention. As surgical complications (n=43), vascular complications were encountered in 8 cases; there were 5 cases with renal artery stenosis and 3 with renal vein thrombus. Wound infection was detected in 14 patients. Eighteen patients underwent surgical explorations due to perinephric hematoma during the early postoperative period. Renal allograft rupture due to accelerated rejection was developed in 2 cases. A lower segmental arterial injury occurred in 1 patient during the operation.CONCLUSION: In our series, urological and surgical complications were detected in 11.02% of the recipients. Although complications still encountered, early identification of these complications with proper management strategies significantly decreases the risk of graft loss.Keywords:Living donor kidney transplantation, surgical complication, urological complication.