ABSTRACT
BACKGROUND: Renal transplantation is the treatment of choice for patients with stage V chronic kidney disease, which does not have contraindications to the procedure and is more cost-effective than dialysis treatments and provides better survival and quality of life. OBJECTIVE: The objective of this study was to evaluate the incidence of postoperative complications in kidney transplant recipients in a reference hospital. METHODOLOGY: This was a descriptive and retrospective study involving the analysis of patient records during hospitalization and outpatient treatment. We analyzed the demographics, clinical indicators, surgical techniques, and postoperative complications. RESULTS: In the analysis of 147 transplantations, there was a higher incidence of transplantation in female recipients, average age of 37 years with a predominance of cadaveric transplantation. Of all pretransplantation comorbidities, hypertension was the most frequent. The overall incidence of surgical complications was 29.9%, with an incidence of vascular complications of 12.7%, 13.4% of surgical site complications, 8.2% of urologic complications, and 3% of hemorrhagic complications. DISCUSSION: Vascular complications are serious complications and are associated with increased risk of graft loss (relative risk, 8.4), particularly arterial thrombosis. Patients with ureteral anastomosis using Lich-Gregoir technique showed lower urologic complications compared with patients with anastomosis by Leadbetter-Politano technique. CONCLUSION: Surgical complications have different clinical effects, depending on their category. The vascular complications are associated with graft lost.
Subject(s)
Anastomosis, Surgical/methods , Kidney Failure, Chronic/surgery , Kidney Transplantation/methods , Postoperative Complications/epidemiology , Thrombosis/epidemiology , Abscess/epidemiology , Adult , Blood Transfusion , Brazil/epidemiology , Female , Humans , Incidence , Incisional Hernia/epidemiology , Lymphocele/epidemiology , Male , Postoperative Hemorrhage/epidemiology , Postoperative Hemorrhage/therapy , Quality of Life , Renal Dialysis , Reoperation , Retrospective Studies , Surgical Wound Infection/epidemiology , Transplant Recipients , Ureter/surgery , Ureteral Obstruction/epidemiology , Urinary Fistula/epidemiologyABSTRACT
INTRODUCTION: Risk factors traditionally associated with kidney graft dysfunction after transplantation are delayed graft function, acute cellular rejection episodes, deceased donor organ source (particularly more than 50 years old), and HLA mismatch. Socioeconomic factors, such as income, education, and type of health insurance, have been reported in some studies. OBJECTIVE: To evaluate the risk factors traditionally associated with worse function of the transplanted kidney and the role of socioeconomic variables among our population. DESIGN OF STUDY: A cohort with 69 patients transplanted in the period 2003 to 2006 was assessed for predictors for a creatinine clearance estimated to be less than 60 mL/min or stage 3 or greater of renal dysfunction at 1 year of follow-up. CONCLUSION: Upon bivariate regression analysis, acute tubular necrosis [odds ratio (OR) 6.93 (1.9-24), P = .03], and bacterial infection [OR 4.13 (1.4-12), P < .01] were predictors of risk, which was also observed among transplants of kidneys from deceased donors [OR 2.67 (0.9-7.6), P = .07] or donors aged more than 49 years [OR 4.22 (0.9-18.1), P = .06]. Better education was a significant protective factor [OR 0.3 (0.1-0.9), P = .02]. Upon multivariate logistic regression analysis delayed graft function [OR 5.1 (1.3-20.5), P = .02] and severe bacterial infection [OR 3.9 (1.23-12.9), P = .02] were predictors; there was no association with socioeconomic factor.
