Objective. Urinary fistulas and stenoses are the most common complications that may require surgical revision after kidney transplantation. The aim of this study was to retrospectively assess the incidence of and risk factors for early (within 30 days) or late major urological complications (stenoses and fistulas) after kidney transplantation. Patients and Methods. The study population comprised 1142 consecutive patients who underwent kidney transplantation between January 1990 and September 2007. Endpoints were early and late urological complications (stenoses and fistulas). The variables considered upon multivariate and univariate analyses were: recipient age, sex, etiology of renal failure, number (first/second) and type (single/double/combined with other organs) of kidney transplantations, cold ischemia time, type of urinary reconstruction, stent positioning, as well as donor cause of death, sex, age, and serum creatinine and clearance. We also examined the presence of graft polar arteries, acute rejection episodes, and postoperative graft function. Results. Among 1142 transplantation performed at our center, 100 patients (8.7%) experienced 107 urological complications: 85 (79.4%) were early (56 fistulas, 29 stenoses) and 22 (20.5%) late (7 fistulas and 15 stenoses). Multivariate analysis for all complications revealed significant associations with male recipient sex (P=.00, HR=2), while first kidney transplantation was protective (P=.00, HR=.4). Male gender both of the recipient and of the donor was significantly associated with early fistulas (P=.01, HR=2.5 and P=.02, HR=2, respectively). First (versus second) kidney transplantation had a protective effect on early stenoses (P=.01, HR=.27). Late fistulas were associated with anastomotic stenting (P=.03) in univariate but not multivariate analysis. Multivariate analysis for late stenoses did not demonstrate any significant association with the considered variables; however, the late stenosis cases showed significantly higher recipient and donor ages (P
Urological Complications After Kidney Transplantation: Experience of More Than 1000 Transplantations / Neri F; Tsivian M; Coccolini F; Bertelli R; Cavallari G; Nardo B; Fuga G; Faenza A.. - In: TRANSPLANTATION PROCEEDINGS. - ISSN 0041-1345. - ELETTRONICO. - 41(4):(2009), pp. 1224-1226. [10.1016/j.transproceed.2009.03.044]
Urological Complications After Kidney Transplantation: Experience of More Than 1000 Transplantations
NERI, FLAVIA;BERTELLI, RICCARDO;CAVALLARI, GIUSEPPE;NARDO, BRUNO;FUGA, GIOVANNI;FAENZA, ALESSANDRO
2009
Abstract
Objective. Urinary fistulas and stenoses are the most common complications that may require surgical revision after kidney transplantation. The aim of this study was to retrospectively assess the incidence of and risk factors for early (within 30 days) or late major urological complications (stenoses and fistulas) after kidney transplantation. Patients and Methods. The study population comprised 1142 consecutive patients who underwent kidney transplantation between January 1990 and September 2007. Endpoints were early and late urological complications (stenoses and fistulas). The variables considered upon multivariate and univariate analyses were: recipient age, sex, etiology of renal failure, number (first/second) and type (single/double/combined with other organs) of kidney transplantations, cold ischemia time, type of urinary reconstruction, stent positioning, as well as donor cause of death, sex, age, and serum creatinine and clearance. We also examined the presence of graft polar arteries, acute rejection episodes, and postoperative graft function. Results. Among 1142 transplantation performed at our center, 100 patients (8.7%) experienced 107 urological complications: 85 (79.4%) were early (56 fistulas, 29 stenoses) and 22 (20.5%) late (7 fistulas and 15 stenoses). Multivariate analysis for all complications revealed significant associations with male recipient sex (P=.00, HR=2), while first kidney transplantation was protective (P=.00, HR=.4). Male gender both of the recipient and of the donor was significantly associated with early fistulas (P=.01, HR=2.5 and P=.02, HR=2, respectively). First (versus second) kidney transplantation had a protective effect on early stenoses (P=.01, HR=.27). Late fistulas were associated with anastomotic stenting (P=.03) in univariate but not multivariate analysis. Multivariate analysis for late stenoses did not demonstrate any significant association with the considered variables; however, the late stenosis cases showed significantly higher recipient and donor ages (PI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
