Impact of early surgical complications on kidney transplant outcomes

BMC Surg. 2024 May 27;24(1):165. doi: 10.1186/s12893-024-02463-7.

Abstract

Background: Kidney transplantation (KT) improves clinical outcomes of patients with end stage renal disease. Little has been reported on the impact of early post-operative surgical complications (SC) on long-term clinical outcomes following KT. We sought to determine the impact of vascular complications, urological complications, surgical site complications, and peri-graft collections within 30 days of transplantation on patient survival, graft function, and hospital readmissions.

Methods: We conducted a single-centre, observational cohort study examining adult patients (≥ 18 years) who received a kidney transplant from living and deceased donors between January 1st, 2005 and December 31st, 2015 with follow-up until December 31st, 2016 (n = 1,334). Univariable and multivariable analyses were performed with Cox proportional hazards models to analyze the outcomes of SC in the early post-operative period after KT.

Results: The cumulative probability of SC within 30 days of transplant was 25%, the most common SC being peri-graft collections (66.8%). Multivariable analyses showed significant relationships between Clavien Grade 1 SC and death with graft function (HR 1.78 [95% CI: 1.11, 2.86]), and between Clavien Grades 3 to 4 and hospital readmissions (HR 1.95 [95% CI: 1.37, 2.77]).

Conclusions: Early SC following KT are common and have a significant influence on long-term patient outcomes.

Keywords: Clinical outcomes; Kidney; Surgical complications; Transplantation.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome