Surgical Results and Factors on Graft Survival in Cadaveric Kidney Transplantation: Siriraj Experience
Keywords:
graft survival, cadaveric, kidney transplantationAbstract
Background: To evaluate the surgical results of cadaveric kidney transplantation and evaluate the factors on graft survival in our center.
Methods: From January 2001 to December 2008, 176 isolated cadaveric kidney transplantations were performed in urological division, Siriraj hospital. The data of patientûs demographics, surgical outcomes, early graft function and graft survival were reviewed from 172 inpatient chart retrospectively.
Results: Mean recipient age was 40.29+11.55 (range 6-65) years. There were 98 male and 74 female recipients. Mean cold ischemia time was 20.18+6.22 (range 4-35) hours. There were 32% (55/172) of early surgical complications. Surgical complications included 30 of lymphatic complications, 13 of bleeding complications, 4 of vascular complication, 3 of ureteral complications, 2 of wound complications and 2 of gastrointestinal complication. There were 2.3% (4/172) perioperative mortalities. Mean follow up time was 4.4 years. The 5-year graft survival of recipient with surgical complications was 68.5% compared to 78.7% (p=0.019) in non surgical complication group. There were 52.6% recipients with delayed graft function. The 5-year graft survival of recipients with delayed graft function was 69.4% compared to 83.9 % (p=0.019) of recipients with immediate graft function.
Conclusion: Cadaveric kidney transplantation is the effective treatment in patients with end stage renal disease; however the early surgical complications may compromise the transplant outcome. Moreover there may be the risk of perioperative mortalities. Delayed graft function may affect the long-term graft survival also.
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