Surgical Complications After Kidney Transplantation Based On The Clavien Classification, Especially With Regard To The Types Of Ureteral Anastomoses

Introduction: Complications associated with postoperative intervention may affect graft and patient survival after kidney transplantation. Monitoring the effectiveness of surgery is an important aspect. Ureter anastomosis can be the pivot of kidney transplant, the same as vascular anastomosis, so efficiency of the surgical technique is important to follow up. Objective and method: We retrospectively examined kidney transplants performed between 2010 and 2020 at the Department of Surgery of the University of Debrecen. Data were analyzed by the SPSS statistical program. We aimed to investigate surgical complications, which were systematized based on the modified Clavien classification. In one patient, the most severe complication was used as the basis for the schedule. The minimum follow-up time was 1 year. Results: 406 kidney transplants were performed in the examined period, of which 24.4% (n = 99) developed renal transplant complications (surgical, radiological, urological). The mean age of the patients was 49.5 +/- 13.7 years, and 60.8% were male. The cumulative mortality was 10.1%. Grade 4 complication developed in 6.9% (n = 28) of the recipients, Grade 3 in 6.7% (n = 27), Grade 2 in 3% (n = 12), and Grade 1 in 7.9% (n = 32). 20.4% of the recipients had delayed graft function. Conclusion: The Grade 1 group had the biggest case number, so a significant part of the complications could be solved with the help of interventional radiology and urologists. There is no significant association between the surgical technique of ureteral anastomoses and the development of related complications. With appropriate therapy, graft and patient survival are not significantly impaired by the development of Grade 1-3 complications.