aula transplante renal
TRANSCRIPT
TRANSPLANTE RENAL IMPLANTE DO ENXERTO E
COMPLICACcedilOtildeES
Incisatildeo do receptor
Incisatildeo de
Gibson e Hockey-
stick
Acesso retroperitoneal
IMPLANTE VASCULAR
Anastomose tradicional anastomose arterial primeiro reduz tempo de oclusatildeo venosa e risco de TVP Veia costuma ser mais longa e por isso maior risco de kink e trombose da veia Dar preferecircncia do rim doado esquerdo (veia mais longa) a ser implantado na fossa iliacuteaca direita
IMPLANTE VASCULAR FIO PROLENE 6-0 NA VEIA E 5-0 NA ARTERIA
SUSPRESAS
IMPLANTE VASCULAR
Segunda opccedilatildeo complicaccedilatildeo impotecircncia
IMPLANTE VASCULAR
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
Incisatildeo do receptor
Incisatildeo de
Gibson e Hockey-
stick
Acesso retroperitoneal
IMPLANTE VASCULAR
Anastomose tradicional anastomose arterial primeiro reduz tempo de oclusatildeo venosa e risco de TVP Veia costuma ser mais longa e por isso maior risco de kink e trombose da veia Dar preferecircncia do rim doado esquerdo (veia mais longa) a ser implantado na fossa iliacuteaca direita
IMPLANTE VASCULAR FIO PROLENE 6-0 NA VEIA E 5-0 NA ARTERIA
SUSPRESAS
IMPLANTE VASCULAR
Segunda opccedilatildeo complicaccedilatildeo impotecircncia
IMPLANTE VASCULAR
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE VASCULAR
Anastomose tradicional anastomose arterial primeiro reduz tempo de oclusatildeo venosa e risco de TVP Veia costuma ser mais longa e por isso maior risco de kink e trombose da veia Dar preferecircncia do rim doado esquerdo (veia mais longa) a ser implantado na fossa iliacuteaca direita
IMPLANTE VASCULAR FIO PROLENE 6-0 NA VEIA E 5-0 NA ARTERIA
SUSPRESAS
IMPLANTE VASCULAR
Segunda opccedilatildeo complicaccedilatildeo impotecircncia
IMPLANTE VASCULAR
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE VASCULAR FIO PROLENE 6-0 NA VEIA E 5-0 NA ARTERIA
SUSPRESAS
IMPLANTE VASCULAR
Segunda opccedilatildeo complicaccedilatildeo impotecircncia
IMPLANTE VASCULAR
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
SUSPRESAS
IMPLANTE VASCULAR
Segunda opccedilatildeo complicaccedilatildeo impotecircncia
IMPLANTE VASCULAR
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE VASCULAR
Segunda opccedilatildeo complicaccedilatildeo impotecircncia
IMPLANTE VASCULAR
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE VASCULAR
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE VASCULAR
Outra opccedilatildeo
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
MAIS SURPRESAS ARTEacuteRIAS MUacuteLTIPLAS
TEacuteCNICAS DE RECONSTRUCcedilAtildeO ARTERIAL DO ENXERTO
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
TEacuteCNICAS PARA ALONGAR VEIA RENAL
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
DOADOR RENAL INFANTIL
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
DIURESE PRESENTE
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE URETERAL
Lich-Gregoir (MacKinnon)
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE URETERAL
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
IMPLANTE URETERAL
bull OUTRAS TEacuteCNICAS DE URETERONEOCISTOSTOMIA
ndash Politano-Leadbetter
ndash Taniguch
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
bull DIRETAS
bull Cushing
bull D mellitus bull GastriteUGD
bull Pancreatite
bull Mielodepressatildeo
bull Nefrotoxicidade
bull Hepatotoxicidade
bull Alteraccedilatildeo comportamental
bull Catarata
bull Necrose oacutessea
bullINDIRETAS
bull Infecccedilotildees
- Fungos
- Bacteacuterias
- Viacuterus
- Parasitas
bull Neoplasias
Kidney transplant recipients are more likely to develop cancer than age-matched subjects in the general population and patients wait-listed for deceased donor renal transplantation ( Kasiske et al 2004)
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
COMPLICACcedilOtildeES CLIacuteNICAS DA IMUNOSUPRESSAtildeO
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
Complicaccedilatildeo imunoloacutegica
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
Complicaccedilotildees vasculares
bull Estenose de arteacuteria renal 17
bull Trombose de arteacuteria renal 17
bull Trombose de veia renal 14
bull Linfocele 12
Risaliti A et all G Ital Nefrol 2004
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
Complicaccedilatildeo vascular
Surgical intervention for transplant renal artery stenosis is difficult with a significant risk of technical failure and percutaneous transluminal angioplasty with or without endoluminal stent placement has become the initial treatment of choice ( Nicita et al 1998 )
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
COMPLICACcedilOtildeES UROLOGICAS
Because the renal transplant is denervated the patient will not experience typical renal colic and the diagnosis is suspected when renal function suddenly deteriorates or transplant pyelonephritis occurs
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
COMPLICACcedilOtildeES UROLOacuteGICAS
bull ITU 285
bull Fiacutestula urinaacuteria 67
bull Estenose ureteral 14
bull Tratamento
ndash Minimamente invasivo
ndash Re-implante ureteral
Burmeister D et all Urologe A 2006
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
CAUSAS DE PERDA DO ENXERTO ()
Rejeiccedilatildeo hiperaguda
15
Rejeiccedilatildeo aguda
150
Rejeiccedilatildeo crocircnica
210
Causa vascular
136
Causa uroloacutegica
00
Recidiva da doenccedila de base
28
Oacutebito c rim funcionante
352
Rutura renal 07
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
Unadjusted Graft and Patient Survival at 3 Months 1 Year 3 Years 5 Years and 10 YearsSurvival ()
Source OPTNSRTR Data as of May 1 2008
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
bull Urologe A 2006 Jan45(1)25-31 Review German[Urological complications after kidney transplantation]
bull [Article in German] bull Burmeister D Noster M Kram W Kundt G Seiter H bull Urologische Klinik und Poliklinik Universitaumlt E-Heydemann-Strasse 6 18055
Rostock dirkburmeistermeduni-rostockde bull Abstract bull Between August 1981 and May 2005 1065 consecutive kidney transplants were
performed at our center 393 patients (369) developed urological complications in the first 60 postoperative days Urinary tract infections occurred in 285 of all patients The major urological problems seen were urinary leakage and ureteral obstruction in 62 and 14 of the patients Two grafts were lost due to severe urinary leakage No patient death occurred due to urological complications The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy With double-J stenting of the extravesical ureteroneocystostomy we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications
bull G Ital Nefrol 2004 Jan-Feb21 Suppl 26S43-7 bull [Surgical complications after kidney transplantation] bull [Article in Italian] bull Risaliti A Sainz-Barriga M Baccarani U Adani GL Montanaro D Gropuzzo M Tullissi
P Boscutti G Lorenzin D Mioni G Bresadola F bull Unita Trapianti Clinica Chirurgica dellUniversita degli Studi di Udine PUGD
arisalitimeduniudit bull Abstract bull Chronic renal failure needs substitutive treatment such as haemodialysis and
peritoneal dialysis for the patient to survive Kidney transplantation (KTx) improves survival of the patient with chronic renal failure Since the first KTx performed by Merrill in Boston in 1959 advances in medical therapy immunosuppressive therapy and refinements in surgical technique have improved the quality of life of the transplant patient We present a review of the incidence diagnosis and therapy of surgical complications after KTx reported in the literature and a retrospective analysis of 297 consecutive cadaveric donor kidney transplants done in our institution from September 1993 to September 2002 Vascular complications represent 5-10 of postoperative complications Our experience showed an incidence of 17 renal artery thrombosis 14 renal vein thrombosis 17 renal artery stenosis 14 arterial rupture due to fungal arteritis 07 spontaneous graft ruptures and 12 lymphoceles Urological complications account for 10-15 of postoperative complications In our series we found an incidence of 74 urinary leakage 27 urinary obstruction and 3 urinary reflux Gastrointestinal complications represent 16 of postoperative complications Our series showed 1 pancreatitis with an overall mortality of 33 and an incidence of 17 intestinal perforations Surgical complications still represent a challenge that increments morbidity and mortality among kidney transplant recipients Data shown may offer some guidance on how to deal with early and late post-transplant surgical complications