Canlý donörden böbrek transplantasyonunda cerrahi ve ürolojik komplikasyonlarýn 789 olguda güncellenmiþ analizi: Tek bir merkez tecrübesi

AMAÇ: Bu çalýþmanýn amacý, 789 canlý donörden böbrek transplantasyon (CDBT) olgusunda cerrahi ve ürolojik komplikasyonlarýn geriye dönük olarak deðerlendirilmesidir.
GEREÇ VE YÖNTEM: Anabilim dalýmýzda 1983 ve 2017 yýllarý arasýnda yapýlan 789 CDBT olgusunun klinik bilgileri cerrahi ve ürolojik komplikasyonlar bakýmýndan geriye dönük olarak deðerlendirildi.
BULGULAR: Ürolojik ve cerrahi komplikasyonlar 87 (%11.02) olguda tespit edildi. Olgularýn 44’ünde (%5.6) görülen ürolojik komplikasyonlar sekiz olguda üriner fistül (1’i distal üreter nekrozu ile birlikte), 10 olguda üreter stenozu, 1 olguda renal kalkül, 9 olguda semptomatik vezikoüreteral reflü ve 16 hastada giriþim gerektiren lenfosel idi. Cerrahi komplikasyonlar ise (n=43), 5’i renal arter stenozu ve 3’ü renal ven trombozu olmak üzere toplam 8 olguda vasküler komplikasyon, 14 yara yeri enfeksiyonu, 18 erken ameliyat sonrasý cerrahi eksplorasyon gerektiren perinefrik hematom, 2 akselere rejeksiyon nedeniyle renal allograft rüptürü ve bir ameliyat sýrasýnda alt segmental arter hasarý idi.
TARTIÞMA: Çalýþmamýzda ürolojik ve cerrahi komplikasyonlar alýcýlarýn %11.2’sinde saptanmýþtýr. Bu komplikasyonlarýn erken tanýnmasý ve uygun stratejilerle yönetilmesi greft kaybý riskini anlamlý ölçüde azaltmaktadýr.

An updated analysis of the surgical and urological complications of 789 living-related donor kidney transplantations: Experience of a single center

BACKGROUND: This study aims to review retrospectively the surgical and urological complications encountered in 789 cases of living-related donor kidney transplantations (LRDKTs).
METHODS: In this study, the clinical records of 789 LRDKTs, which were performed between 1983 and 2017, were reviewed retrospectively concerning surgical and urological complications.
RESULTS: Overall, urological and surgical complications were encountered in 87 (11.02%) of the cases. Of the 789 patients, urological complications were detected in 44 of them (5.6%), including 8 urinary fistula (with 1 distal ureteral necrosis), 10 ureteric stenosis, 1 renal calculus, 9 symptomatic vesicoureteral reflux and 16 lymphoceles requiring intervention. As surgical complications (n=43), vascular complications were encountered in 8 cases; there were 5 cases with renal artery stenosis and 3 with renal vein thrombus. Wound infection was detected in 14 patients. Eighteen patients underwent surgical explorations due to perinephric hematoma during the early postoperative period. Renal allograft rupture due to accelerated rejection was developed in 2 cases. A lower segmental arterial injury occurred in 1 patient during the operation.
CONCLUSION: In our series, urological and surgical complications were detected in 11.02% of the recipients. Although complications still encountered, early identification of these complications with proper management strategies significantly decreases the risk of graft loss.