Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors”
Urological complications (UC) following kidney transplantation (KT) are associated with increased morbidity. The aim of this study is to evaluate the risk factors for UC in the era of “extended criteria donors” (ECD) and their impact on patient and graft survivals. A retrospective monocentric study...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Transplantology |
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| Online Access: | https://www.mdpi.com/2673-3943/2/1/3 |
| _version_ | 1797409133447610368 |
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| author | Roberta Angelico Marco Pellicciaro Francesca Venza Tommaso Maria Manzia Roberto Cacciola Alessandro Anselmo Luca Toti Andrea Monaco Giuseppe Iaria Giuseppe Tisone |
| author_facet | Roberta Angelico Marco Pellicciaro Francesca Venza Tommaso Maria Manzia Roberto Cacciola Alessandro Anselmo Luca Toti Andrea Monaco Giuseppe Iaria Giuseppe Tisone |
| author_sort | Roberta Angelico |
| collection | DOAJ |
| description | Urological complications (UC) following kidney transplantation (KT) are associated with increased morbidity. The aim of this study is to evaluate the risk factors for UC in the era of “extended criteria donors” (ECD) and their impact on patient and graft survivals. A retrospective monocentric study of all patients undergoing KT from 2010 to 2019 with a follow-up ≥30 days was performed. Out of 459 patients (males: 296 (64.5%); age: 57 (19–77) years) enrolled, 228 (49.7%) received ECD organs, moreover, 166 (67.2%) grafts had a cold ischemia time ≥10 h. UCs were reported in 32 (7%) patients. In 21 (65.6%) cases UC occurred within 3 months post-KT and 24 (5.2%) were associated with early urinary tract infection (UTI). The overall 5 year patient and graft survival rates were 96.5% and 90.6%, respectively. UC decreased graft survival (UC-group: 75.0% vs. noUC-group: 91.8%, <i>p</i> < 0.001), especially if associated with early UTI (UC-group: 71.4% vs. noUC-group: 77.8%, <i>p</i> < 0.001). At multivariate analysis, early UTI after KT (OR: 9.975, 95%-IC: 2.934–33.909, <i>p</i> < 0.001) and delayed graft function (DGF) (OR: 3.844, 95%-IC: 1.328–11.131, <i>p</i>: 0.013) were significant risk factors for UC, while ECD graft did not increase the risk of post-transplant UC. ECD grafts are not associated with UC. DGF and early UTI post-KT increase the risks of UC and reduce graft survival in the long-term. Therefore, aggressive management of early post-transplant UTI and strategies to reduce DGF incidence, such as machine preservation, are essential to prevent UC after KT. |
| first_indexed | 2024-03-09T04:08:57Z |
| format | Article |
| id | doaj.art-b297df32de244cda8fc9db13e5f0d440 |
| institution | Directory Open Access Journal |
| issn | 2673-3943 |
| language | English |
| last_indexed | 2024-03-09T04:08:57Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Transplantology |
| spelling | doaj.art-b297df32de244cda8fc9db13e5f0d4402023-12-03T14:02:50ZengMDPI AGTransplantology2673-39432021-01-0121223610.3390/transplantology2010003Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors”Roberta Angelico0Marco Pellicciaro1Francesca Venza2Tommaso Maria Manzia3Roberto Cacciola4Alessandro Anselmo5Luca Toti6Andrea Monaco7Giuseppe Iaria8Giuseppe Tisone9HPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyHPB and Transplant Unit, Department of Surgical Sciences, University of Rome Tor Vergata, Viale Oxford 33, 00133 Rome, ItalyUrological complications (UC) following kidney transplantation (KT) are associated with increased morbidity. The aim of this study is to evaluate the risk factors for UC in the era of “extended criteria donors” (ECD) and their impact on patient and graft survivals. A retrospective monocentric study of all patients undergoing KT from 2010 to 2019 with a follow-up ≥30 days was performed. Out of 459 patients (males: 296 (64.5%); age: 57 (19–77) years) enrolled, 228 (49.7%) received ECD organs, moreover, 166 (67.2%) grafts had a cold ischemia time ≥10 h. UCs were reported in 32 (7%) patients. In 21 (65.6%) cases UC occurred within 3 months post-KT and 24 (5.2%) were associated with early urinary tract infection (UTI). The overall 5 year patient and graft survival rates were 96.5% and 90.6%, respectively. UC decreased graft survival (UC-group: 75.0% vs. noUC-group: 91.8%, <i>p</i> < 0.001), especially if associated with early UTI (UC-group: 71.4% vs. noUC-group: 77.8%, <i>p</i> < 0.001). At multivariate analysis, early UTI after KT (OR: 9.975, 95%-IC: 2.934–33.909, <i>p</i> < 0.001) and delayed graft function (DGF) (OR: 3.844, 95%-IC: 1.328–11.131, <i>p</i>: 0.013) were significant risk factors for UC, while ECD graft did not increase the risk of post-transplant UC. ECD grafts are not associated with UC. DGF and early UTI post-KT increase the risks of UC and reduce graft survival in the long-term. Therefore, aggressive management of early post-transplant UTI and strategies to reduce DGF incidence, such as machine preservation, are essential to prevent UC after KT.https://www.mdpi.com/2673-3943/2/1/3urological complicationskidney transplantationextended criteria donormarginal organsmachine perfusiondelayed graft function |
| spellingShingle | Roberta Angelico Marco Pellicciaro Francesca Venza Tommaso Maria Manzia Roberto Cacciola Alessandro Anselmo Luca Toti Andrea Monaco Giuseppe Iaria Giuseppe Tisone Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors” Transplantology urological complications kidney transplantation extended criteria donor marginal organs machine perfusion delayed graft function |
| title | Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors” |
| title_full | Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors” |
| title_fullStr | Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors” |
| title_full_unstemmed | Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors” |
| title_short | Urological Complications in Kidney Transplant Recipients: Analysis of the Risk Factors and Impact on Transplant Outcomes in the Era of “Extended Criteria Donors” |
| title_sort | urological complications in kidney transplant recipients analysis of the risk factors and impact on transplant outcomes in the era of extended criteria donors |
| topic | urological complications kidney transplantation extended criteria donor marginal organs machine perfusion delayed graft function |
| url | https://www.mdpi.com/2673-3943/2/1/3 |
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