Barba Javier, Algarra Ruben, Romero Luis, Tienza Antonio, Velis Jose Maria, Robles Jose Enrique, Zudaire Juan Javier, Pascual Ignacio
Department of Urology, University of Navarra Clinic, Pamplona, Spain.
Scand J Urol. 2013 Feb;47(1):63-71. doi: 10.3109/00365599.2012.700945. Epub 2012 Jul 10.
The aim of this study was to evaluate recipient and donor risk factors that are related to surgical complications after renal transplantation.
In total, 419 kidney transplantations were analysed with regard to the influence of recipient and donor risk factors on the main postoperative surgical complications.
The mean follow-up for the entire group was 72.8 months (± 54.2 SD). Vascular complications were independently associated with donor age; and urological complications with recipient age >65 years and cyclosporine rather than tacrolimus therapy. Wound complications were independently associated with recipient age, preoperative dialysis time, recipient body mass index (BMI) and cyclosporine rather than tacrolimus therapy. Collections were independently associated with retransplantation, type 2 diabetes mellitus and wound complications. Overall surgical complications were associated with donor age and delayed graft function. In terms of severity, grade I complications were independently associated with recipient age and surgical revision, grade II with recipient age >50 years, grade III with recipient BMI, and grade IV with donor age.
Recipient characteristics are the primary determinants of wound, urological and minor (Clavien grades I, II and III) complications; however, graft or donor characteristics are the primary risk factors for vascular, overall and major (Clavien grade IV) surgical complications.
本研究旨在评估与肾移植术后手术并发症相关的受者和供者风险因素。
总共分析了419例肾移植手术，探讨受者和供者风险因素对主要术后手术并发症的影响。
整个研究组的平均随访时间为72.8个月（标准差±54.2）。血管并发症与供者年龄独立相关；泌尿系统并发症与年龄>65岁的受者以及使用环孢素而非他克莫司治疗有关。伤口并发症与受者年龄、术前透析时间、受者体重指数（BMI）以及使用环孢素而非他克莫司治疗独立相关。积液与再次移植、2型糖尿病和伤口并发症独立相关。总体手术并发症与供者年龄和移植肾功能延迟有关。在严重程度方面，I级并发症与受者年龄和手术翻修独立相关，II级与年龄>50岁的受者相关，III级与受者BMI相关，IV级与供者年龄相关。
受者特征是伤口、泌尿系统及轻微（Clavien分级I、II和III级）并发症的主要决定因素；然而，移植物或供者特征是血管、总体及严重（Clavien分级IV级）手术并发症的主要风险因素。
