Retrospective analysis of the first 100 kidney transplants at XXXXXXX XXXX University, Health Application and Research Center (original) (raw)
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Objectives: The renal transplant program of Istanbul Okan University Hospital started in August 2017. Five cadaveric and 95 living donor kidney transplants have been performed for over 16 months. In this study, we aimed to share our experiences regarding kidney transplantation. Methods: In this study, a retrospective analysis of 100 patients who underwent kidney transplantation at the Istanbul Okan University over 16 months, the Health Application and Research Center was carried out. Patients’ demographics, creatinine levels of donors and recipients, co-morbid conditions, postoperative complications, features of arterial anastomosis and arterial variations observed on computed tomography angiography of donor-patient were assessed. Results: Mean age of donor patients was 44.05±13.76 (18-71) years. All living donors had computed tomography angiography for assessment of the vascular structure of both kidneys. Accessory right kidney artery was the most dominant vascular variation (16.5%). The primary cause of chronic renal disease was diabetes mellitus (36.4%) and hypertension (15.6%). Mean warm and cold ischemia time was 1.82±0.44 (1-3) and 40.25±6.12 (31-57) minutes, respectively. The most observed postoperative complication was stenosis of ureter anastomosis (4.1%). End-to-end arterial anastomosis between renal and internal iliac arteries was the most preferred anastomosis (57.2%). Conclusion: Increasing kidney transplantation, which is the most appropriate treatment in terms of cost-effectiveness, will be beneficial for patient health and economy of the country.
2014
The aim of this research was to determine the correlation of early vascular posttransplant complications with the type and age of the kidney donor and the recipient. Kidney transplantation is a method of choice in the treatment of terminal renal failure which enables patients to return to a healthy, productive way of life. Nowadays, a kidney is transplanted from a live donor and frequently often from cadavers. The most important early postoperative vascular complications are: renal artery thrombosis, renal vein thrombosis and bleeding. The aim of the study was to examine the correlation of early vascular posttransplant comlications with the type and age of the kidney donor and the recipient. The research was performed on 43 patients who had undergone a kidney transplantation at the Clinic of Vascular Surgery, Clinical Centre Niš, within the period from 2009 to 2012. There was not a significant difference between live donors and cadavers (p<0.5) with regard to early vascular complications. The difference in occurrence of vascular complications in relation to age shows statistically significantly greater occurrence of complications when donors are persons older than 60 years (p<0.05) and recipients older than 40 years (p<0.05). The type of a kidney donor is not connected to the frequency of early vascular complications. Early post-transplant vascular complications occur more often in kidney recipients older than 40 years and donors older than 60 years.
2021
Background and aim Vascular variations of grafts are handled with various reconstruction techniques in renal transplantation. We aimed to analyze the effects of these reconstruction techniques and sites on patient/graft outcomes. Materials and methods Renal transplantation cases at the Transplantation Unit of the General Surgery Department, İstanbul University Cerrahpaşa Medical Faculty between January 1st, 2000 and December 31st, 2012 were analyzed retrospectively. Postoperative duplex ultrasound results, urea-creatinine reduction rates, and complications were evaluated. Results There were 228 living-donor transplantation cases evaluated. For single-renal-artery living-donor transplantations, there were 45 end-to-side external iliac artery, 15 end-to-side internal iliac artery, 152 end-to-end internal iliac artery, and 3 end-to-side common iliac artery anastomoses performed. In cases with double-arteries, 3 had end-to-side external iliac artery anastomoses, and 10 had endto-end int...
Transplantation of both kidneys from 408 donors; comparison of results
Transplant International, 2000
Our earlier yet unpublished data has demonstrated the detrimental effect of delayed onset of graft function (DGF) on allograft survival in cadaveric renal transplantation. Our data showed further that the onset of graft function depends on many donor and recipient factors which alone were not significant factors in determining graft survival (GS). Many studies have demonstrated that long preservation time is a major factor leading to DGF in cadaveric renal transplantation 14, 19] and, therefore, transplantations from living donors ensure the recipient a minimal length of cold ischaemia time (CIT) and usually immediate onset of diuresis . Early inflammatory events caused by long preservation time and reperfusion injury contribute to poor initial graft function and inferior long-term survival . There are, however, factors other than CIT, which, depending on the clinical setting and organ allocation policy, can be more or less involved. To study the impact of these other factors, we examined the outcome of renal transplantations where both kidneys of the donor were transplanted at our centre. Our aim was to minimise the effect of donor and organ procure-ment factors as well as the impact of CIT in this study. We analysed the results of 816 cadaveric renal transplantations performed during 1991±1997 using 408 pairs of kidneys, all retrieved and transplanted within our own transplant programme.
Scripta Medica, 2019
Background: Kidney transplantation is the best treatment for patients with end-stage renal disease (ESRD). The aim of the study was to show the results of kidney transplantation performed in the University Clinical Centre of the Republic of Srpska in the period 2010-2018. Methods: This was a retrospective, 8-year observational cross-sectional study. Studied endpoints were overall patient survival, as well as graft survival rate in kidney transplant recipients. Recipient's age, gender, induction immunosuppressive therapy, the underlying cause of ESRD, the dialysis modality and post-operative complications (surgical, medical, urinary tract infections, electrolyte imbalance, and graft rejection) and their influence on the patient and graft survival rates were monitored. Results: The 30 living-donor kidney transplantations were performed, 29 livingrelated donor and one living-unrelated donor renal transplantation. A total of 70% of kidney recipients were male, and 30% were female. The average age of patient was 34.43 ± 8.67 years. Induction immunosuppressive regimen was prescribed to 76.7% of transplanted patients. Graft rejection occurred in 5 patients (16.7%). The 1-year, 3-year, 5-year, and 8-year patients survival rates were 100%, 100%, 96.97% and 93.33%, respectively. The 1-, 3-, 5-, and 8-year graft survival rates were 100%, 96.97%, 93.33% and 86.67%, respectively. The current mean value of glomerular filtration rate (GFR) in 25 patients with functional graft was 81.8 ± 30.3 ml/min. There was a statistically significant difference in the graft survival rate in the group with urinary tract infections (UTIs) (66.66%) compared to a group without UTIs (100%). Overall patient survival was significantly lower in the group with graft rejection (60%) compared to the group without graft rejection (92%). Kidney graft survival rate and overall patient survival have not been significantly different in terms of the studied factors (recipient's age, gender, induction immunosuppressive treatment, underlying cause of ESRD, dialysis modality, surgical or medical complications, and electrolyte imbalance). Conclusion: The results of living-donor kidney transplantation performed in the University Clinical Center of the Republic of Srpska are good in comparison with the results obtained at other centres.
Outcomes of Kidney Transplantation by Using the Technique of Renal Artery Anastomosis First
Cureus, 2018
Introduction The surgical technique for kidney transplantation has been well established: the renal vein is anastomosed first, followed by renal artery anastomosis. Alternatively, the renal artery can be anastomosed first and then the renal vein for kidney transplantation. However, there is a lack of data on the outcomes of kidney transplantation by using this alternative approach. The objective of this paper was to review the outcomes of kidney transplant by using this approach. Methods A review of 205 consecutive kidney transplants was conducted. All kidney transplants were performed by doing renal artery anastomosis first and then the renal vein. Data were collected, including vascular/urological complications and kidney graft function. Results All transplants were performed successfully with no occurrence of renal artery/vein thrombosis and urine leakage. There were five cases of renal artery stenosis that were managed with endovascular intervention. There was no recurrence on follow-up. One ureteric stenosis required surgical reconstruction. Conclusions This alternative vascular anastomotic technique is efficient and safe. It avoids flip-flopping the kidney graft during the vessel anastomoses and may be more practical in minimally invasive surgery for a kidney transplant due to the space constraint.
Vojnosanitetski pregled, 2020
Background/Aim. Renal transplantation is the best and preferred way of treating patients with end-stage renal disease, as it offers improved survival and better quality of life compared to dialysis. The aim of this study was to present single-center (Military Medical Academy in Belgrade, Serbia) results of the kidney allograft and patient survival from 1996 to 2017. Methods. A retrospective 22-year co-hort study was conducted. Variables of interest were graft and patient survival in kidney transplanted patients. Age, gender, serum creatinine levels, and induction therapy after transplantation were analyzed in this group of patients as well. Results. Among 386 transplanted patients, 316 had a living donor and 70 patients had a deceased donor. Pre-emptive renal transplantation was done in 29 (7.5%) patients and AB0-incompatible kidney transplantation in 21 (5.4%) patients. One-year, 5-year, 10-year, and 20-year overall patient survival after kidney transplantation in the observed grou...
Kidneys for transplant come from a living donor or a deceased (cadaver) donor. When a kidney is transplanted from a living donor, the donor's remaining kidney enlarges to take over the work of two. As with any major operation, there is a chance of complication. Kidney transplantation (KT) can be complicated by medical or surgical complications. Surgical complications after KT may cause kidney graft dysfunction and may have similar clinical manifestations as medical complications. Surgical complications include haemorrhage, vascular complications (renal artery and vein thrombosis or stenosis), urinary complications (urine leaks or ureteral stricture), lymphocele, and wound infection. Haemorrhage is uncommon after KT, and usually resolves spontaneously with conservative management. Renal vascular thrombosis is an uncommon, but serious complication, usually leading to graft loss. Renal artery stenosis (RAS) is a treatable surgical complication post-KT that can cause hypertension and allograft dysfunction. Urologic complications, manifesting as urine leaks or ureteral obstruction, affect about 2-10% of kidney transplant recipients, and are associated with high morbidity, graft loss, and mortality. Lymphoceles occur with an incidence of 0.6-18%, and commonly develop a few weeks to months after KT. Surgical site infections (SSIs), which are one of the most common complications after KT, usually occur within the first month after KT. Surgical complications post-KT can cause significant morbidity that requires early recognition, diagnosis, and immediate treatment to optimize outcomes and graft survival. The Living Donor Sometimes family members, including brothers, sisters, parents, children (18 years or older), uncles, aunts, cousins, or a spouse or close friend may wish to donate a kidney. That person is called a "living donor." The donor must be in excellent health, well informed about transplantation, and able to give informed consent. Any healthy person can donate a kidney safely. Living donor kidney transplants are the best option for many patients for several reasons: Better long-term results No need to wait on the transplant waiting list for a kidney from a deceased donor