Surgical Complications After Kidney Transplantation

BACKGROUND Kidney transplantation is the best therapeutic option for patients with end-stage kidney disease. Despite advances in surgical techniques, the surgical procedure itself is associated with a risk of postoperative complications, with an incidence rate of 5-25%. The aim of this retrospective analysis was to identify risk factors for surgical complications after kidney transplantation. MATERIAL AND METHODS The study included 283 patients who underwent kidney transplantation at our center over an 11-year period (2013-2023). Baseline characteristics of the recipients (age, sex, and type of donor) and factors influencing the development of surgical complications (type of induction therapy, diabetes mellitus, BK positivity) were recorded. Patients who developed a surgical complication (bleeding, lymphocele, ureteral stenosis) were identified and analyzed in relation to potential independent risk factors. RESULTS Surgical complications occurred in 15.8% of patients (n=45), with ureteral stenosis comprising 60% of all surgical complications. The average time to surgical complication onset ranged from 5.4 to 8.6 months. By using Cox proportional-hazard regression multivariate analysis, none of the parameters that were looked at were found to be independent risk factors for the development of surgical complications (endpoints: surgical complications itself, bleeding, ureteral stenosis, lymphocele/lymphorrhea). CONCLUSIONS Kidney transplantation significantly improves quality of life and survival in patients with end-stage kidney disease. Surgical complications remain a significant post-transplant challenge, with urological, vascular, and parietal complications being most common. While we found no independent risk factors among the parameters studied, minimizing these complications is essential to reduce the need for reinterventions and to improve outcomes.