Department of Urology, Philipps-University Marburg, Marburg, Germany.
Reimbursement Institute, Hürth, Germany.
World J Urol. 2024 Feb 1;42(1):65. doi: 10.1007/s00345-023-04740-1.
Kidney transplantation (KT) is the most frequently performed organ transplantation. In Germany, KT is performed in urology and surgery departments with unknown consequences of this parallel structure. The aim of the study was to compare the development and outcome of KT in urology and surgery departments.
On an institutional level, we analyzed the annual caseload from 2006 to 2021 with the reimbursement. INFO tool based on hospitals' quality reports (Reimbursement Institute, Hürth, Germany). For outcome comparison we extracted raw data from the transplantation centers' quality reports (Deutsche Stiftung Organtransplantation, DSO).
A total of 23,599 cases (17,781 deceased donor and 5,818 living donor KTs) were included. The total number of KTs decreased from 1851 in 2006 to 1701 in 2021 (- 8%; p = 0.12). The total number of urological KTs decreased from 592 cases in 2006 to 395 cases in 2021 (- 33.3%; p = 0.01). Further analysis revealed no significant differences between intra- and postoperative complications and graft quality at one year for deceased donor KTs (DDKT) although differences in immediate renal function and graft quality at discharge could be observed. There were no significant differences in immediate renal function and graft quality at discharge for living donor KTs (LDKT) between the specialties.
KTs performed in urology departments declined between 2006 and 2021. Nevertheless, intra- and postoperative complications as well as long-term function did not differ between surgical and urological KT programs. Hence, an interdisciplinary approach, especially considering the upcoming challenges in KT as, e.g., robot-assisted surgery seems reasonable.
肾移植（KT）是最常见的器官移植。在德国，KT 由泌尿科和外科部门进行，这种并行结构的后果尚不清楚。本研究旨在比较泌尿科和外科部门的 KT 发展和结果。
在机构层面上，我们使用基于医院质量报告的 INFO 工具（德国 Hürth 的报销研究所）分析了 2006 年至 2021 年的年度病例数和报销情况。为了进行结果比较，我们从移植中心的质量报告中提取了原始数据（德国器官移植基金会，DSO）。
共纳入 23599 例（17781 例死体供者 KT 和 5818 例活体供者 KT）。KT 的总数从 2006 年的 1851 例减少到 2021 年的 1701 例（-8%；p=0.12）。2006 年泌尿科 KT 的数量从 592 例减少到 2021 年的 395 例（-33.3%；p=0.01）。进一步分析表明，尽管在出院时可以观察到即时肾功能和移植物质量的差异，但在死体供者 KT（DDKT）中，围手术期并发症和移植物质量在一年内没有显著差异。在活体供者 KT（LDKT）中，外科和泌尿科之间在出院时的即时肾功能和移植物质量没有显著差异。
2006 年至 2021 年间，泌尿科进行的 KT 数量有所下降。尽管如此，在泌尿科和外科 KT 方案中，围手术期并发症和长期功能没有差异。因此，考虑到 KT 即将面临的挑战，如机器人辅助手术，采取跨学科的方法似乎是合理的。
