Felix Burkhalter1, Uyen Huynh-Do2, Karine Hadaya3, Maurice Matter4, Thomas Müller5, Isabelle Binet6, Christa Nolte7, Juerg Steiger8. 1. Clinic for Transplant Immunology and Nephrology, University Hospital Basel, Switzerland; Division of Nephrology, Kantonsspital Baselland, Liestal, Switzerland. 2. Department of Nephrology, Hypertension and Clinical Pharmacology, University Hospital Bern, Inselspital, Switzerland. 3. Service of Nephrology, University Hospital of Geneva, Switzerland. 4. Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Switzerland. 5. Department of Nephrology, University Hospital of Zurich, Switzerland. 6. Nephrology and Transplantation medicine, Kantonsspital St. Gallen, Switzerland. 7. Swiss Organ Living Donor Health Registry, University Hospital of Basel, Switzerland. 8. Clinic for Transplant Immunology and Nephrology, University Hospital Basel, Switzerland; Swiss Organ Living Donor Health Registry, University Hospital of Basel, Switzerland.
Abstract
BACKGROUND: We evaluated the prospectively collected data about the incidence of early peri- and postoperative complications, and potential risk factors for adverse outcomes after living kidney donation in Switzerland. METHODS: Peri- and postoperative events were prospectively recorded on a questionnaire by the local transplant teams of all Swiss transplant centres and evaluated by the Swiss Organ Living Donor Health Registry. Complications were classified according to the Clavien grading system. A total of 1649 consecutive donors between 1998 and 2015 were included in the analysis. RESULTS: There was no perioperative mortality observed. The overall complication rate was 13.5%. Major complications defined as Clavien ≥3 occurred in 2.1% of donors. Obesity was not associated with any complications. Donor age >70years was associated with major complications (odds ratio [OR] 3.99) and genitourinary complications (urinary tract infection OR 5.85; urinary retention OR 6.61). There were more major complications observed in donors with laparoscopic surgery versus open surgery (p = 0.048), but an equal overall complication rate (p = 0.094). CONCLUSION: We found a low rate of major and minor complications, independent of surgical technique, after living donor nephrectomy. There was no elevated complication rate in obese donors. In contrast, elderly donors >70 years had an elevated risk for perioperative complications.
BACKGROUND: We evaluated the prospectively collected data about the incidence of early peri- and postoperative complications, and potential risk factors for adverse outcomes after living kidney donation in Switzerland. METHODS: Peri- and postoperative events were prospectively recorded on a questionnaire by the local transplant teams of all Swiss transplant centres and evaluated by the Swiss Organ Living Donor Health Registry. Complications were classified according to the Clavien grading system. A total of 1649 consecutive donors between 1998 and 2015 were included in the analysis. RESULTS: There was no perioperative mortality observed. The overall complication rate was 13.5%. Major complications defined as Clavien ≥3 occurred in 2.1% of donors. Obesity was not associated with any complications. Donor age >70years was associated with major complications (odds ratio [OR] 3.99) and genitourinary complications (urinary tract infection OR 5.85; urinary retention OR 6.61). There were more major complications observed in donors with laparoscopic surgery versus open surgery (p = 0.048), but an equal overall complication rate (p = 0.094). CONCLUSION: We found a low rate of major and minor complications, independent of surgical technique, after living donor nephrectomy. There was no elevated complication rate in obese donors. In contrast, elderly donors >70 years had an elevated risk for perioperative complications.
Authors: Susanne Stampf; Nicolas J Mueller; Christian van Delden; Manuel Pascual; Oriol Manuel; Vanessa Banz; Isabelle Binet; Sabina De Geest; Pierre-Yves Bochud; Alexander Leichtle; Stefan Schaub; Jürg Steiger; Michael Koller Journal: BMJ Open Date: 2021-12-15 Impact factor: 2.692