Early Postoperative Surgical Complications After Kidney Transplantation
Özet
Kidney transplantation is the most ideal treatment method for end-stage renal disease; however, early surgical complications developing within the first 30 to 90 days postoperatively remain a significant threat to graft and patient survival. This chapter reviews the incidence, pathophysiology, diagnosis, and management of major early urological and surgical complications, including ureteral strictures, urinary leaks, ureteral necrosis, and perigraft collections (hematomas, urinomas, lymphoceles, and abscesses). Ischemia, primarily due to the disruption of the "golden triangle" blood supply, and the presence of multiple arteries in the donor are the main risk factors for ureteral complications. The early diagnostic process relies heavily on ultrasonography, biochemical fluid analysis, and targeted radiological imaging. Treatment strategies emphasize the critical role of prompt intervention, ranging from percutaneous drainage and endoscopic procedures to early surgical revision. Furthermore, the advantages and disadvantages of routine prophylactic Double-J stent placement are discussed, highlighting its protective role against strictures and leaks when properly managed alongside the risk of infection. In conclusion, a multidisciplinary approach involving nephrology, transplant surgery, and interventional radiology ensures the successful management of these early complications, achieving long-term graft survival rates similar to those of uncomplicated transplants.
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