Transplant nephrectomy over 20 years: factors involved in associated morbidity and mortality

Of 1,048 renal transplants performed between 1971 and 1990, transplant nephrectomy was performed in 86 (8.2%). Mean patient age was 33 years (range 3.8 to 66.5). Postoperative complications occurred in 60% of the patients, including wound infection in 20% and major hemorrhage in 4 patients. The exte...

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Bibliographic Details
Published inThe Journal of urology Vol. 151; no. 4; p. 855
Main Authors O'Sullivan, D C, Murphy, D M, McLean, P, Donovan, M G
Format Journal Article
LanguageEnglish
Published United States 01.04.1994
Subjects
Adolescent
Adult
Aged
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Kidney Transplantation - adverse effects
Kidney Transplantation - mortality
Male
Middle Aged
Nephrectomy - adverse effects
Nephrectomy - statistics & numerical data
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative Complications - surgery
Reoperation
Treatment Failure
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Summary:Of 1,048 renal transplants performed between 1971 and 1990, transplant nephrectomy was performed in 86 (8.2%). Mean patient age was 33 years (range 3.8 to 66.5). Postoperative complications occurred in 60% of the patients, including wound infection in 20% and major hemorrhage in 4 patients. The external iliac artery was ligated in 4 patients. The incidence and severity of the complications were greater in patients with acute rejection. Four patients died: 1 of ischemic bowel and metastatic carcinoma, 1 of pulmonary embolism, and 2 of sepsis and disseminated intravascular coagulation. The nephrectomy rate increased significantly (p < 0.005) when cyclosporine A was initially introduced. Added care is necessary when new immunosuppressants are used. The majority of our failed transplants were left in situ without compromising overall patient well-being.
ISSN:0022-5347
DOI:10.1016/S0022-5347(17)35105-4