Study of surgical complications between primary and secondary renal transplants

Introduction. In a retrospective study we reviewed the surgical complications of primary and secondary renal transplants in 1108 consecutive renal transplants. Patients and methods. Between 1992 and 2001, 1108 consecutive renal transplants were performed using living related and unrelated donors. Sixty-five second grafts (group 1) were performed in patients of mean age 34.5 (range 18 to 55) and 1043 primary renal transplants (group 2) in patients of mean age 38.2 (range 10 to 63). One case in group 1 and 94 cases in group 2 were diabetic patients. Factors analyzed were vascular, wound, ureteral, and lymphocele complications. Results. The follow-up period ranged from 10 to 120 months (average 27.3). The mean creatinine level in patients with active grafts was 1.45 mg/dL. The last creatinine levels in the two groups were not significantly different. The rates of surgical complications were 4.6% in group 1 and 3.8% in group 2, including vascular complications (one case in group 1 and 16 in group 2), wound problems (nobody in group I and seven cases in group 2), lymphocele (two cases in group 1 and eight cases in group 2), and ureteral complications (nobody in group 1 and nine cases in group 2). The incidence of complications between the two groups did not show a significant difference (P =.72). Conclusion. With some changes in the standard operation, surgical complications in second renal transplants are not more frequent than among the primary transplants. Therefore, we strongly recommend a second renal transplant when the primary graft has failed.