Influencing factors of difficulty in allogeneic kidney transplantation
10.3760/cma.j.cn115396-20220127-00034
- VernacularTitle:同种异体肾移植手术难度的影响因素分析
- Author:
Jingcheng LYU
1
;
Yuwen GUO
;
Lei ZHANG
;
Zhipeng WANG
;
Jian ZHANG
;
Yichen ZHU
Author Information
1. 首都医科大学附属北京友谊医院泌尿外科，北京 100050
- Keywords:
Kidney transplantation;
Factor analysis, statistical;
Renal dialysis;
Operative difficulty;
Obesity;
Vessel anastomosis
- From:
International Journal of Surgery
2022;49(10):663-668
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the factors related to the difficulty of adult allogeneic renal transplantation.Methods:Used retrospective study method, a total of 183 patients who were diagnosed with end-stage renal disease and underwent allogeneic kidney transplantation in Beijing Friendship Hospital, Capital Medical University from January 2020 to December 2021 were included in this study. With kidney transplant operation time as the evaluation criteria of operation difficulty, relevant clinical indicators that may affect the difficulty of surgery were collected, including recipient age, body mass index, pretransplant dialysis mode, blood lipid level, subcutaneous fat thickness, vascular anastomosis mode, donor kidney length, donor kidney volume, etc. Pearson, Spearman correlation test were used to analyze the correlation between the above indexes and surgical difficulty.Results:In terms of recipients, higher body mass index ( P=0.006), peritoneal dialysis before transplantation ( P=0.035), higher serum cholesterol ( P=0.016) and triglyceride ( P<0.001), thicker subcutaneous fat ( P=0.032) and calcification of the vessels ( P<0.001) all lead to increase the difficulty of kidney transplantation, and also prolong the operation time; in terms of kidney donors, the longer and larger of transplanted kidney length ( P<0.001) and volume ( P<0.001), the longer operation time will be cost. Meanwhile, the anastomosis of complex multi-vessel between kidney transplantation and recipient was more difficult than single internal iliac artery and single external iliac artery anastomosis ( P=0.005), and the operation time was also longer. Conclusions:The degree of obesity before transplantation, dialysis mode, blood lipid level, donor kidney size and vascular anastomosis mode were all factors affecting the difficulty of kidney transplantation. For patients with those above risk factors, the operation may be difficult and the surgical time can be much longer. Physicians with more experience in kidney transplantation can be selected to shorten the operation time, even reduce complications after operation.
