POS-727 Surgical complications and cardiovascular comorbidity : confounders of survival after kidney transplantation

Abstract

Surgical complications following kidney transplantation compromise immediate graft survival. However, the role of early surgical complications in the impairment of long-term survival can be distort due to patient cardio-vascular comorbidities. In this study we characterize surgical complications and identify patient comorbidities. We compare the impact of surgical complications on graft function and survival after kidney transplantation in the presence or absence of comorbidities. The study was conducted in the nephrology department: Kidney transplant unit, at the Fattouma Bourguiba hospital in Monastir. It’s a retrospective and descriptive study. From 2007 to 2019,103 patients undergoing kidney transplantation. Surgical complications were analyzed (Graft artery stenosis, ureter necrosis, lymphocele, hematoma, wound infection, double J probe obstruction). Graft and patient survival, general patient characteristics, cardio-vascular comorbidities (diabetes mellitus, arterial hypertension, vein thrombosis), immunosuppression, and immunological characteristics were determined. Post-transplant graft function as well as long-term graft and patient survival were quantified. An overall estimate of renal survival was 69.4 months : 63.8/75.83 months with/without comorbidities. Graft survival was 87% /97% (1year), 83%/92% (3years), and 43%/52% (5years) with/without comorbidities respectively. Patient survival was 100%/100%% (1year), 50%/85%(3years), and 15%/18%(5years) with/without comorbidities respectively. Whereas pre-existing cardio-vascular disease affected graft loss and patient survival. These observations were confirmed by Cox regression the long-term prognosis of kidney transplants is to some degree determined by the occurrence of surgical complications. However, this effect is interlinked with the influence of cardiovascular comorbidities.