Urological and surgical complications of renal transplant recipients as a single-center experience

Abstract

Background: Kidney transplantation is considered the most effective therapy for end-stage renal disease (ESRD). Postoperative complications continue to occur in nearly 12–20% of patients. These complications can be sub-divided into three categories: vascular, urologic, and nephrogenic. Objective: To determine the surgical and urological complications of renal transplant in Basra Training Center. Patients and Methods: A prospective descriptive study was done on 71 patients who underwent renal transplant surgery between October 2015 and August 2018. After taking their informed consent, preoperative antibiotics were given, and the procedure was done under general anesthesia. In all the transplantations, the renal vein of the donor was anastomosed to the external iliac vein of the recipient with an end-to-side. While the renal artery anastomosed to the internal iliac artery of the recipient with an endto-end for the first 50 cases, in the other 21 cases, renal artery anastomosed to the external iliac artery of the recipient with an end-to-side anastomosis. Ureters were anastomosed by the Lich–Gregoire procedure. Results: Overall, urological and surgical complications were encountered in 12 of the renal transplants recipients from the total number (71, 17%). This study included a total of 71 patients (59 male and 12 female, 83% and 17%, respectively). The complications that occurred during the follow-ups of the patients were as follows: one patient developed urinary leak (1.4%), five patients developed lymphocele (7%), four patients complained of acute pyelo nephritis (6%), one patients (1.4%) complained of wound infection, and one complained of renal stone (1.4%). Conclusions: In conclusion, urological complications such as lymphocele (7%) and acute graft pyelonephritis (AGPN) (6%) remain the most common type of surgical complications following kidney transplantation (in this study). Our urological and surgical complication rate was relatively low compared to others noted in the literature. Keywords: Kidney transplantation, ESRD, urinary leak, lymphocele