Blichová Tímea, Kleinová Patrícia, Vnučák Matej, Graňák Karol, Kollár Andrej, Svihra Jan, Miklušica Juraj, Dedinská Ivana
Transplant-Nephrology Department, University Hospital Martin, Martin, Slovakia.
Clinic of Internal Medicine I, University Hospital Martin and Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia.
Ann Transplant. 2025 Jun 10;30:e948531. doi: 10.12659/AOT.948531.
BACKGROUND Kidney transplantation is the best therapeutic option for patients with end-stage kidney disease. Despite advances in surgical techniques, the surgical procedure itself is associated with a risk of postoperative complications, with an incidence rate of 5-25%. The aim of this retrospective analysis was to identify risk factors for surgical complications after kidney transplantation. MATERIAL AND METHODS The study included 283 patients who underwent kidney transplantation at our center over an 11-year period (2013-2023). Baseline characteristics of the recipients (age, sex, and type of donor) and factors influencing the development of surgical complications (type of induction therapy, diabetes mellitus, BK positivity) were recorded. Patients who developed a surgical complication (bleeding, lymphocele, ureteral stenosis) were identified and analyzed in relation to potential independent risk factors. RESULTS Surgical complications occurred in 15.8% of patients (n=45), with ureteral stenosis comprising 60% of all surgical complications. The average time to surgical complication onset ranged from 5.4 to 8.6 months. By using Cox proportional-hazard regression multivariate analysis, none of the parameters that were looked at were found to be independent risk factors for the development of surgical complications (endpoints: surgical complications itself, bleeding, ureteral stenosis, lymphocele/lymphorrhea). CONCLUSIONS Kidney transplantation significantly improves quality of life and survival in patients with end-stage kidney disease. Surgical complications remain a significant post-transplant challenge, with urological, vascular, and parietal complications being most common. While we found no independent risk factors among the parameters studied, minimizing these complications is essential to reduce the need for reinterventions and to improve outcomes.
背景 肾移植是终末期肾病患者的最佳治疗选择。尽管手术技术有所进步,但手术本身仍存在术后并发症风险,发生率为5% - 25%。本回顾性分析的目的是确定肾移植术后手术并发症的危险因素。
材料与方法 本研究纳入了在我们中心11年期间(2013 - 2023年)接受肾移植的283例患者。记录受者的基线特征(年龄、性别和供体类型)以及影响手术并发症发生的因素(诱导治疗类型、糖尿病、BK病毒阳性)。确定发生手术并发症(出血、淋巴囊肿、输尿管狭窄)的患者,并针对潜在的独立危险因素进行分析。
结果 15.8%的患者(n = 45)发生了手术并发症,其中输尿管狭窄占所有手术并发症的60%。手术并发症发生的平均时间为5.4至8.6个月。通过Cox比例风险回归多变量分析,在所研究的参数中,没有一个被发现是手术并发症发生的独立危险因素(终点:手术并发症本身、出血、输尿管狭窄、淋巴囊肿/淋巴漏)。
结论 肾移植显著改善了终末期肾病患者的生活质量和生存率。手术并发症仍然是移植后一个重大挑战,其中泌尿外科、血管和腹壁并发症最为常见。虽然我们在所研究的参数中未发现独立危险因素,但将这些并发症降至最低对于减少再次干预的需求和改善预后至关重要。