Early vascular complications of renal transplantation

Abstract

Early vascular complications were studied in 1300 consecutive renal transplantations performed in 1065 patients in a single institution. Vascular complications requiring surgical reintervention in the first 10 postoperative days occurred in 68 patients (5.2%). There were 33 instances of graft vessel thrombosis, 6 anastomotic and 30 extra‐anastomotic hemorrhages. The overall mortality as a result of these complications was 0.08%. Transplant nephrectomies were performed in 45/68 cases (66%), accounting for 3.5% graft loss of the complete series. Multiple renal arteries and veins, their reconstruction and multiple arterial or venous anastomoses were not associated with an increased chance of graft loss. The absence of an aortic patch, renal artery and vein lesions and extravascular graft anomalies did not exert a negative influence on the graft outcome. Intraoperative events leading to complete or partial revision of the venous anastomosis or repair of a troublesome venous hemorrhage proved to be associated with the occurrence of vascular complications requiring surgical reintervention. Vascular complications ensued most frequently when size discrepancy of graft and recipient was present.