Surgical Wound Dehiscence in Kidney Transplantation: Risk Factors and Impact on Graft Survival

Abstract

Surgical wound dehiscence (SWD) is a frequent complication after kidney transplantation (KT) but there is not enough evidence of its impact on graft survival. A retrospective cohort study including all KT patients with SWD in our center from January 2015 to July 2020 was performed. A case-control study was performed and for each case of SWD, 2 controls were selected (2:1). To identify risk factors for SWD, a logistic regression analysis was carried out and a multivariable Cox regression was used to describe risk factors for graft survival. In our center, 503 KT were performed, and 39 patients presented SWD. They were older (62.1 vs 57.1 years; P=.030), most had diabetes mellitus (59% vs 28.6%; P=.002) and their body mass index was higher (31 vs 26.9 kg/m2; P < .001). In multivariable logistic regression analysis, diabetes mellitus (P=.024) and a body mass index ≥30 kg/m2 at time of transplantation (P=.018) were predictors of SWD. A higher rate of delayed graft function was described in SWD (P=.013) and it was associated with a longer hospital stay (20.9 vs 15 days; P=.004). Graft survival was lower in patients with SWD (P=.036). In multivariable Cox regression analysis, time in renal replacement therapy (P=.020) and SWD (P=.028) were predictors of shorter graft survival. SWD is a risk factor for graft survival. The presence of diabetes mellitus and a higher body mass index are predictors for the appearance of this complication.