Servicio de Urología, Hospital Universitario Joan XXIII, Tarragona, Spain.
Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
Arch Esp Urol. 2022 Oct;75(8):720-728. doi: 10.56434/j.arch.esp.urol.20227508.104.
Complications in donation after circulatory death (DCD) kidney transplants (KT) are barely described, while in some urological complications the cause is unknown. The aim of this study is to describe surgical and urological complications and analyze what donation features could be involved.
A prospective, single center study was performed from 2016 to 2019 including all KT from controlled cardiac death donors (cDCD).
A total of 86 cDCD KT were included in the study. Recipient BMI, residual urine output (RUO) <500 mL/day, delayed graft function (DGF), and wound complication were related to UTI ( = 0.020, = 0.008, = 0.016, and = 0.004, respectively). Features related to early graft nephrectomy were recipient BMI and recipients with diabetes mellitus (DM) ( = 0.025 and = 0.036, respectively). DM in recipients was significantly associated with hematuria ( = 0.046). Urinary leak (UL) was associated to vascular complication and ureteral stricture (US) ( = 0.029 both). UL and lymphocele were associated to US ( = 0.029 both). Features related to lymphocele were recipient BMI and US ( = 0.028 and = 0.029, respectively). History of previous transplant, time from cardiac arrest (CA) to cold flush, and DGF, were associated to wound complication ( = 0.040, = 0.011 and = 0.016, respectively).
Surgical and urological complications after KT are an important issue to resolve. Our data revealed an association between RUO <500 mL/day, DGF, and wound complication with urinary infection, as well as between recipient DM and hematuria. Recipient BMI and DM were related to early graft nephrectomy. Vascular complications were associated with urinary leak, and lymphocele with US. Finally, wound complication was related to previous transplant, DGF, and time from CA to cold flush. This data revealed interesting associations between donor and recipient features and cDCD KT complications, providing more information to improve prevention and management.
循环死亡（DCD）供肾移植（KT）后的并发症几乎没有描述，而在一些泌尿科并发症中，病因尚不清楚。本研究的目的是描述手术和泌尿科并发症，并分析哪些捐献特征可能与之相关。
这是一项从 2016 年至 2019 年进行的前瞻性、单中心研究，包括所有来自心脏控制死亡供体（cDCD）的 KT。
共有 86 例 cDCD KT 纳入本研究。受者 BMI、残余尿量（RUO）<500ml/天、延迟移植物功能（DGF）和伤口并发症与 UTI 相关（=0.020、=0.008、=0.016 和=0.004）。与早期移植肾切除术相关的特征是受者 BMI 和患有糖尿病（DM）的受者（=0.025 和=0.036）。受者的 DM 与血尿显著相关（=0.046）。尿漏（UL）与血管并发症和输尿管狭窄（US）相关（两者均=0.029）。UL 和淋巴囊肿与 US 相关（两者均=0.029）。与淋巴囊肿相关的特征是受者 BMI 和 US（=0.028 和=0.029）。既往移植史、心脏骤停（CA）至冷冲洗时间和 DGF 与伤口并发症相关（=0.040、=0.011 和=0.016）。
KT 后手术和泌尿科并发症是一个需要解决的重要问题。我们的数据显示，RUO<500ml/天、DGF 和伤口并发症与尿路感染之间存在关联，以及受者 DM 与血尿之间存在关联。受者 BMI 和 DM 与早期移植肾切除术相关。血管并发症与尿漏相关，淋巴囊肿与 US 相关。最后，伤口并发症与既往移植、DGF 和 CA 至冷冲洗时间有关。这些数据揭示了供体和受者特征与 cDCD KT 并发症之间的有趣关联，为改善预防和管理提供了更多信息。
