Early Complications after Non Related Allograft Kidney Transplantation: Incidence and Management Experience of 800 Cases in Iraq

Abstract

ABSTRACT
Background: The number of potential renal transplant recipients far exceeds the number
of cadaveric donors. For this reason, living related donors and, living unrelated donors
have been used to decrease the cadaveric donor shortage. Complications are common in
both the immediate postoperative period and later after kidney transplantation. But most of
these complications when managed accordingly had no effect on the graft survival.
Objectives: To study the incidence and management of early complications; that
occurred within the first month after transplantation, in 800 kidney transplanted patients
from living unrelated donors.
Methods: A case series descriptive study including 800 patients with renal failure
underwent non related allograft kidney transplantation from May 1996 to February 2002, in
a private hospital in Baghdad. Focusing on the incidence and management of early
complications; that occurred within the first month after kidney transplantation.
Results: Eight hundreds patients, 552(69%) were males, 248(31%) were females. The
age range of the donors was 19-54 (mean 30.39±9.32) years, while the age range of the
recipients was 7-70 (mean 31.40±11.35) years. The reported complications were, urinary
tract infection in 312(39%) patients, urine leak 28(3.5%), ureteric stoma edema 2(0.2%),
clot retention 7(0.8%), wound seroma 12(1.5%), wound hematoma 6(0.7%), wound
infection 7(0.8%), wound dehiscence 2(0.2%), paralytic ileus 2(0.2%), acute pancreatitis
1(0.1%), acute gastric erosion 1(0.1%), hematemesis and malena 4(0.5%), lymphocele
9(1.1%), postoperative bleeding 1(0.1%), deep venous thromboses 19(2.3%), arterial
thromboses 1(0.1%), venous thromboses 1(0.1%), hyper acute rejection 1(0.1%),
accelerated acute rejection 8(1%), acute rejection 120(15%), rupture graft 1(0.1%),
arrhythmia 32(4%), acute ventricular failure 11(1.3%), myocardial infarction 2(0.2%),
angina pectoris 23(2.8%), chest infection 28(3.5%), acute tubular necrosis 4(0.5%),
Sandimmun toxicity 28(3.5%), nephrectomy 6(0.7%). The one-month patient survival was
98.6% and graft survival was 99.2%.
Conclusion: Complications occur in the immediate postoperative period after kidney
transplantation. But most of these complications had no effect on the graft survival, when
managed accordingly.