Renal Transplantation as a Platform for Teaching Residents Open Vascular Surgical Techniques: Effects on Early Graft Function

The Kidney Transplant: Maintaining Excellent Outcomes While Increasing Skills Acquisition

OBJECTIVE/BACKGROUND

Kidney transplantation is a complex operation that incorporates multiple fundamental surgical techniques and is an excellent opportunity for surgical skill development during residency training. We hypothesized that increasing resident competency, measured as anastomosis time, could be demonstrated while maintaining high-quality surgical outcomes during the learning process.

METHODS

We performed a retrospective cohort study of surgical resident involvement in kidney transplantation and recorded the anastomosis time. The study population comprised adult, single organ kidney transplants (n = 2052) at a large academic transplant center between 2006 and 2019. Descriptive statistics included frequencies, medians, and means. A mixed model of anastomosis time on number of procedures was fitted. Poisson models were fitted with outcomes of the number of patients with delayed graft function and number of patients that underwent reoperation postoperatively, with the exposure being number of kidney transplants performed by resident.

RESULTS

Results from the mixed model suggest that as the number of times a resident performs the surgery increases, the time to conduct the operation decreases with statistical significance. The Poisson regression demonstrated no significant relationship between the operative volume of a resident and postoperative complications.

CONCLUSION

This study demonstrated statistical evidence that with an increase in the number of renal transplantations performed by a surgical resident, anastomosis time decreased. It also demonstrated no significant relationship between number of kidney transplants performed by a resident and postoperative complications, suggesting that patient outcomes for this operation are not adversely affected by resident involvement.

RETRACTED:Predictive Factors of Surgical Complications in the First Year Following Kidney Transplantation

This article has been retracted: please see Elsevier Policy on Article Withdrawal ( https://www.elsevier.com/locate/withdrawalpolicy ). The article has been retracted at the request of the last author, Sebastien Deglise, due to significant violations of research standards during the course of the study which do not ensure the reliability of the published data and of which the author has informed the journal that he was unaware at the time of the publication.