Early Postoperative Surgical Complications After Kidney Transplantation
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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