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Impact of surgeon's experience on vascular and haemorrhagic vomplications after kidney transplantation

Objective - The aim of this study was to investigate the independent risk factors of vascular and haemorrhagic complications after kidney transplantation (KTx) and to evaluate how the surgeon's experience affects the rate of vascular and haemorrhagic complications. - Methods - After exclusion o...

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Main Authors: Kulu, Yakup (Author) , Tinoush, Parham (Author) , Golriz, Mohammad (Author) , Khajeh, Elias (Author) , Sabagh, Mohammad Sadegh (Author) , Ghamarnejad, Omid (Author) , Mieth, Markus (Author) , Ulrich, Alexis (Author) , Hackert, Thilo (Author) , Müller, Beat P. (Author) , Strobel, Oliver (Author) , Michalski, Christoph (Author) , Morath, Christian (Author) , Zeier, Martin (Author) , Büchler, Markus W. (Author) , Mehrabi, Arianeb (Author)
Format: Article (Journal)
Language:English
Published: 2019
In: European journal of vascular and endovascular surgery
Year: 2019, Volume: 57, Issue: 1, Pages: 139-149
ISSN:1532-2165
DOI:10.1016/j.ejvs.2018.07.041
Online Access:Verlag, Volltext: https://doi.org/10.1016/j.ejvs.2018.07.041
Verlag: http://www.sciencedirect.com/science/article/pii/S1078588418305203
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Author Notes:Yakup Kulu, Parham Fathi, Mohammad Golriz, Elias Khajeh, Mohammadsadegh Sabagh, Omid Ghamarnejad, Markus Mieth, Alexis Ulrich, Thilo Hackert, Beat P. Müller-Stich, Oliver Strobel, Christoph Michalski, Christian Morath, Martin Zeier, Markus W. Büchler, Arianeb Mehrabi
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Summary:Objective - The aim of this study was to investigate the independent risk factors of vascular and haemorrhagic complications after kidney transplantation (KTx) and to evaluate how the surgeon's experience affects the rate of vascular and haemorrhagic complications. - Methods - After exclusion of paediatric and multi-organ transplantations, 1462 KTx operations between 2000 and 2016 were analysed. Independent risk factors were evaluated by multivariable logistic regression analysis. The generalised estimating equation logit model was used to display learning curve progression and determine the best cut off number of KTx operations to reduce vascular and haemorrhagic complications. - Results - Vascular and haemorrhagic complications occurred in 38 KTx cases (2.6%). Renal vein thrombosis was the most common complication (0.6%). Graft loss occurred in 11 of 38 (28.9%) cases. Donor age of >60 years (OR 3.687, 95% CI 1.663-8.175, p = 0.001), recipient cardiovascular disease (CVD) (OR 2.270, 95% CI 1.071-4.810, p = 0.032), and surgeon's experience (OR 0.875, 95% CI 0.783-0.977, p = 0.018) were independent predictors of vascular and haemorrhagic complications. Twenty-six previous KTx operations are needed to decrease predicted probability of post-KTx vascular and haemorrhagic complications below 2.6%. - Conclusions - The surgeon's experience is an independent risk factor for vascular and haemorrhagic complications after KTx. Acceptable post-operative vascular and haemorrhagic complications are achieved after a minimum of 26 KTx. As a donor age of >60 years and recipient CVD are also independent risk factors for vascular and haemorrhagic complications, it is suggested that these patients should preferably be operated on by surgeons who have performed more than 26 KTx operations.
Item Description:Available online 17 September 2018
Gesehen am 31.10.2019
Physical Description:Online Resource
ISSN:1532-2165
DOI:10.1016/j.ejvs.2018.07.041

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