Böbrek Nakli Operasyonuyla ilişkili Komplikasyonların Erken Dönem Hasta ve Graft Sonuçları Üzerine Etkisi

Öz

Böbrek nakli sonrası erken dönem hasta ve graft sağkalımı, birbiriyle ilişkili birçok karmaşık faktöre bağlıdır. Bu çalışmada; canlı ve kadaverik vericiden böbrek nakli yapılan hastalarda intra- ve post-operatif gelişen medikal ve cerrahi komplikasyonların sıklığı ve bu komplikasyonların erken dönemde hasta ve graft sağkalımı üzerine olan etkileri araştırıldı. Tek merkezde on yıllık dönemde böbrek nakli yapılan 498 hasta verileri retrospektif olarak incelendi. Alıcıların demografik, diyaliz ve nakil bilgileriyle, intra- ve post-operatif komplikasyonlar tıbbi kayıtlardan elde edildi. Komplikasyon gelişimi ile hasta ve graft sağkalımını etkileyen risk faktörler değerlendirildi. Çalışmamızda, canlı vericili nakillerde intra-operatif cerrahi komplikasyon, kadaverik vericili nakillerde post-operatif medikal ile post-operatif medikal ve cerrahi komplikasyon sıklığı anlamlı olarak yüksek saptandı. Gündüz çalışma saatleri dışında yapılan operasyonlarda post-operatif medikal komplikasyonlar daha sık görüldü. Post-operatif cerrahi komplikasyon ile post-operatif medikal ve cerrahi komplikasyon görülmesi ise istatistiksel olarak graft sağkalım süresini ve hasta sağkalım süresini anlamlı olarak kısalttı. İntra-operatif medikal ve cerrahi komplikasyon gelişiminde; verici yaşındaki 1 birimlik artış komplikasyon riskini 1.027 kat arttırdı. Nakil öncesi diyaliz modalitesinin hemodiyaliz olması, periton diyalizi olmasına kıyasla intraoperatif medikal ve cerrahi komplikasyon gelişme riskini 3.816 kat arttırdı. Sonuç olarak, gözlemlerimiz erken dönemde medikal ve cerrahi komplikasyonların sık görüldüğünü ve bu komplikasyonların hasta ve graft sağkalımını etkileyebileceğini düşündürmektedir.

Anahtar Kelimeler

• Böbrek nakli
• Komplikasyon
• Graft fonksiyonu

Destekleyen Kurum

Destekleyen kurum bulunmamaktadır

Etik Beyan

Etik Kurul Onay Bilgisi: Onaylayan Kurul: Bursa Uludağ Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu Onay Tarihi: 29.11.2016 Karar No: 2016-20/9

Teşekkür

Yazarlar, çalışmaya dahil edilen böbrek nakli alıcılarının hazırlık, operasyon ve operasyon sonrası bakım ve tedavisinde görev alan Dr. Hakan Vuruşkan ve Dr. Gürkan Türker başta olmak üzere tüm hekim, hemşire ve sağlık personeline, ayrıca çalışma verilerinin analizine katkısından dolayı Dr. Gülser Çalışkan’a teşekkür eder.

Impact of Kidney Transplantation-related Complications on Patient and Graft Outcomes in Early Period

Öz

Early patient and graft survival after kidney transplantation depends on many complex, interrelated factors. In this study, we aimed to evaluate the frequency of intra- and post-operative medical and surgical complications in kidney transplant patients and the effects of these complications on patient and graft survival in the early period. The data of patients who underwent kidney transplantation in a single centre in ten years were examined retrospectively. Recipients' demographics, dialysis and transplantation information, and intra- and post-operative complications were obtained from medical records. Risk factors affecting the development of complications and patient and graft survival were evaluated. In our study, the frequency of intra-operative surgical complications in transplants with living donors and the frequency of post-operative medical and post-operative medical and surgical complications in transplants with deceased donors was found to be significantly higher. Post-operative surgical complications and post-operative medical and surgical complications statistically significantly shortened the graft and patient survival times. In the development of intra-operative medical and surgical complications, a 1-unit increase in donor age increased the risk of complications by 1.027 times (OR: 1.027, 95% CI: 1.003-1.052, p=0.026). Peritoneal dialysis as the pre-transplant dialysis modality reduced the risk of developing intra-operative medical and surgical complications by 73.8% compared to hemodialysis (OR: 0.262, 95% CI: 0.079-0.863, p=0.028). As a result, it has been observed that medical and surgical complications are common in the early period, and these complications can affect patient and graft survival. In conclusion, early medical and surgical complications are common in kidney transplant recipients, and these complications may affect patient and graft survival.

Anahtar Kelimeler

• Kidney transplantation
• Graft function
• Complication

Kaynakça

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