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KMID : 0361119940080010023
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Korean Journal of Transplantation
1994 Volume.8 No. 1 p.23 ~ p.32
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Surgical Complications and their Management in 1,200 Renal Transplant Patients
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Abstract
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Surgical complication of renal transplantation may lead to the disastrous consequence such as graft loss, patient´s morbidity and mortality. The incidence of surgical complication which had been up to 25% of renal transplantation in the past decreased below 10% or less.
But the surgical complications are still significant causes of graft loss, postoperative morbidity and mortality. The incidence of early vascular complication is 3.58.0% and that of urologic complication is 9.0^-12.5% in the literature review. Between the April 1979 to August 1994, twelve hundred renal transplants were done at Yonsei University medical center. The authors analyzed the kinds and incidence of surgical complications in a large single center experience by using the information from hospital records. The results were as follows: The overall surgical complication rate is 9.3%(112 episodes in 101 patients). The majority of complications are postoperative bleeding(3.1% 38ca.ses), urologic complications (3. 3% 40cases) and gastrointestinal bleeding(0.75% 9 cases). The other minor complications are wound hematoma, wound infection, wound disruption, incisional hernia and iymphocele. The most common vascular complication is postoperative bleeding or hematoma during early postoperative period. The most common urologic complications are urine leakage in early postoperative period and bladder stones in late period.
The major type of postoperative complication in early period are bleeding & urine leak-age and in late period are bladder stone, urinary obstruction and peptic ulcer disease. There were three complication related mortality.
In conclusion; Atraumatic donor organ harvest, secure vascular anastomosis, water tight but not narrow ureteroneocystostomy, and meticulous hemostasis could keep surgical complications at a minimum. Early diagnosis followed by early agrressive surgical treatment could rescue both graft and patient.
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