4.6 Article

Evaluation of technical urinary tract complications in kidney transplantation recipients with a prolonged dialysis history

Journal

SURGERY
Volume 174, Issue 2, Pages 136-141

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.surg.2023.02.013

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This study aims to evaluate post-kidney transplant complications in patients with a history of prolonged dialysis. The study found that in high-risk patients with prolonged dialysis and anuria, the rate of technical urinary tract complications remained low.
Background: The kidney transplant waiting list continues to expand, resulting in prolonged dialysis times exceeding 8 years before transplantation in some regions. The relationship between long-term dialysis and urinary tract complications after kidney transplant remains largely unexplored. This study aims to evaluate post-kidney transplant complications in patients with a history of prolonged dialysis.Methods: A single-center, retrospective cohort study of patients maintained on dialysis & GE;8 years before kidney transplant between January 2000 and July 2020 was conducted. Clinical variables, including demographics and comorbidities, were reviewed. The primary objective was the development of a technical urinary tract complication. Secondary outcomes included any postoperative complication by type, stratified by medical and surgical complications.Results: Overall, 376 patients met the inclusion criteria. The mean pre-kidney transplant dialysis time was 10.2 & PLUSMN; 2.6 years. The majority (65.7%) of the study participants were anuric. Four patients (1.1%) experienced a urine leak, and 8 patients (2.1%) had a ureteral stricture. Any complication was observed in 111 (29.5%) patients, with urinary tract infections being the most common. Urinary catheters remained in place for a median of 4 (3, 5) days. Drains were commonly used (62.8%) for a median of 5 (4, 6) days.Conclusion: In our large, single-center experience with kidney transplants in high-risk patients with prolonged dialysis and anuria, the technical urinary tract complications rate remained low. With the current literature consisting of small cohorts and having relatively short pre-kidney transplant dialysis periods, our analysis addresses the shortcomings of the literature while suggesting that this patient population may not truly be high risk.& COPY; 2023 Elsevier Inc. All rights reserved.

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