Bull Acad Natl Med. 2011 Feb;195(2):351-62; discussion 362-3.
Bulletin de l'Academie nationale de medecine
[Article in French] Gérard Benoît
PMID: 22096874
This article reviews a series of 3,000 consecutive kidney transplantations. Vascular and urinary complications occurred in respectively 7.4 % and 9.8 % of recipients. Arterial and venous thrombosis and urinary fistulas were the most serious complications. The frequency of arterial stenosis fell from 18.8 % to 8.9 % when the artery was implanted in the external rather than the internal iliac artery. The frequency of artery stenosis fell from 15.9 % to 9.5 % when the right renal vein was extended by using the transected cadaver vena cava. Urinary fistulas were an early complication, but their incidence fellfrom 6.6 % to 2.8 % with the use of JJstents. Urinary stenosis remained frequent (5.4 %) despite the use of JJstents. Surgical and endoscopic treatment of renal artery stenosis gave very similar success rates (82 %), indicating that dilation of a stenosed artery is a good option when medical treatment fails. Endourological treatment of urinary complications was successful on 64 % of fistulas and 46 % of stenoses. The results of this series and an analysis of the literature show the importance of improving the organ harvest technique and reducing the cold ischemia time, which is the main reason for delayed recovery of graft function.
