Complicaciones quirúrgicas en el trasplante renal y su influencia en la supervivencia del injerto

Abstract

Objectives To analyze surgical complications in kidney transplantation and their influence on graft survival. Materials and methods A retrospective analysis was made of the early and late surgical complications occurring in 216 consecutive kidney transplants performed at our institution and their influence on graft survival. Results At least one surgical complication occurred in 82 (38%) of the 216 transplantations, and 68 (31%) required some type of repeat surgery, 23 in the early postoperative period and 45 more than 3 months after surgery. Mean follow–up was 48 months (SD +/−33.4), and median follow–up 48 months (range, 0–166 months). No recipient or donor factors predisposing to surgical complications were found. Graft survival was significantly shorter in patients with surgical complications [3- and 5-year survival rates of 86% (95% CI 83%–89 %) and 78% (95% CI 73%–82%) as compared to 92% (95% CI 90%–94%) and 88% (95% CI 85%–91%), p:0.004]. Early repeat surgery, venous thrombosis, and wound infection were among the complications having an independent influence on graft survival. A multivariate analysis of graft survival in the whole group showed early repeat surgery to be a factor with an independent prognostic value (OR: 4.7; 95% CI 2.2–10, p<0.0001). Delayed function and donor age older than 60 years were the other independent influential factors. Conclusion Surgical complications have an influence on graft survival. The need for early repeat surgery, delayed function, and donor age older than 60 years are independent predictors of graft survival.