Complications After Upper Extremity Surgery in Solid Organ Transplant Patients

Area of Science:

• Orthopedic Surgery
• Transplant Surgery
• Patient Safety

Background:

• Solid organ transplant (SOT) recipients often require surgical interventions.
• Upper extremity procedures in SOT patients may carry unique risks.
• Understanding complication rates is crucial for patient management.

Purpose of the Study:

• To determine the incidence of complications following upper extremity surgery in SOT patients.
• To identify risk factors associated with these complications.

Main Methods:

• Retrospective review of SOT patients undergoing upper extremity procedures from 2006-2018.
• Data collected included demographics, transplant details, surgical procedures, and complications (within 1 year for surgical, 30 days for medical).
• Complications were classified using the Clavien-Dindo system.

Main Results:

• A total of 51 procedures in 32 SOT patients were analyzed, with an overall complication rate of 41%.
• Surgical infections were the most common complication, occurring equally before and after 30 days post-surgery.
• Male patients had a higher likelihood of complications compared to female patients; no significant differences were noted based on age, ASA score, transplant type, or immunosuppression.

Conclusions:

• Upper extremity operations in SOT patients are associated with a high complication rate.
• Surgical complications can manifest beyond the typical 30-day window, necessitating extended monitoring.
• SOT patients should be informed of their elevated risk and the potential need for prolonged post-operative surveillance.