General surgical complications associated with renal allotransplantation using related donors

Cadaveric renal transplantation: surgical results and expectations in the cyclosporine era

During a 36-month period 100 patients received 104 cadaveric renal transplants with cyclosporine-based immunosuppression. Of the patients 26 required 31 additional operations. Of the 19 secondary operations performed 1 month after transplantation 18 were emergency in nature, whereas beyond this period the majority of the procedures were elective. Both deaths in this series were related to the operation. Only 1 graft loss was directly attributed to a secondary operation. The patient undergoing cadaveric renal transplantation is at significant risk (25 per cent) of requiring at least 1 additional operation. However, despite this high probability of reoperation, graft loss and patient death after such procedures should be rare.

Elective and emergency surgery in renal transplant patients

Additional operations were necessary in 67 (41%) of 162 renal allograft patients. General anesthesia was employed in all but 5 patients with no morbidity or mortality. All patients were immunosuppressed and no additional steroids were used before, during, or after the procedure. The source of the donor kidney made no difference in predicting if a recipient would require post-transplantation surgery or if an emergency or elective operation was required. Oerations were necessary to correct complications either directly related to the transplant procedure (71%), or medical problems of immunosuppression or uremia (21%). Nine patients (6%) required operations unrelated to transplantation. The data indicate that transplant patients frequently need additional procedures which are directly related to the transplant operation, immunosuppression, or metabolic alterations of their past uremic condition. Mortality is related to the degree of toxicity from the immunosuppressive therapy.