Groeneweg, E (2020) Prolonged anastomosis time and complicated vascular anastomosis affect kidney transplant outcome Vascular complications and related factors in kidney transplantation: a retrospective Dutch database study. thesis, Medicine.
Full text available on request.Abstract
Background Currently, kidney transplantation is the preferred treatment in the final stage of chronic kidney disease. During transplantation it is necessary to keep the anastomosis time (AT), the stitching of the donor vessels to the recipient vessels, as short as possible. If a complication would arise during this period, this could influence patient and graft survival. Currently, there is not much known about this complication. Objectives We aim to identify parameters related to prolonged AT, complicated vascular anastomosis and re-anastomosis as well as to investigate the effect on the outcomes: patient survival, graft survival, kidney function and delayed graft function (DGF). Methods A retrospective observative cohort database study was performed. This study was performed kidney transplanted patients at the University Medical Centre of Groningen. The parameters thought to influence prolonged AT, complicated vascular anastomosis and re-anastomosis were selected based on clinical insight and existing scientific knowledge. Results Prolonged AT increased graft loss in the brain death donation donors (DBD) (HR 1.51, 95%CI, 1.02-2.24, P=0.038) and increased the chance of DGF in the living donated kidney category (OR 2.79, 95%CI, 1.24-6.26, P=0.013) and postmortal (PM) category (OR 3.44, 95%CI, 2.41-4.91, P<0.0005). Complicated vascular anastomosis showed a higher hazard for graft loss in DBD patients (HR 1.85, 95CI, 1.10-3.09, P=0.020) and caused a threefold greater chance of DGF in the PM donation category (OR 5.91, 95%CI, 3.84-9.0, P<0.0005). Conclusion Prolonged AT, complicated vascular anastomosis and re-anastomosis are associated with inferior graft outcome. However, future research is necessary on vascular complications
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Drs. Hofker, H. S. and Prof. Leuvenink, H. G. D. |
| Faculty: | Medical Sciences |
| Date Deposited: | 02 Oct 2023 11:39 |
| Last Modified: | 02 Oct 2023 11:39 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3696 |
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