https://doi.org/10.4081/aiua.2021.2.158

Early morning kidney transplantation: Perioperative complications

Vol. 93 No. 2 (2021)
Submitted: January 9, 2021
Accepted: February 23, 2021
Published: June 28, 2021
Early morning transplantation, Kidney transplantation, Kidney transplant complications, Immediate diuresis, Surgery starting hour
Abstract Views: 981
PDF: 419
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Authors

Mário Pereira Lourenço
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Miguel Eliseu
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Duarte Vieira Brito
duartevbrito@hotmail.com
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
João Carvalho
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Edgar Tavares-Silva
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Lorenzo Marconi
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Pedro Moreira
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Pedro Nunes
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Belmiro Parada
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Carlos Bastos
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.
Arnaldo Figueiredo
Urology and Renal Transplantation Department, Coimbra University Hospital Centre, Coimbra, Portugal.

Introduction: To reduce cold ischemia time (CIT), many kidney transplants are performed in the early morning. Conducting complex surgeries in the early morning may influence the surgeon's technical capacity and rate of surgical complications (SC). Aim: Evaluate the influence of surgery start hour (SSH) regarding duration of surgery (DS), immediate diuresis (ID), SC and acute rejection (AR); evaluate the influence of CIT regarding SC, ID, and AR.
Methods: 2855 cadaveric transplants performed between June 1980 and March 2018 were retrospectively evaluated. Regarding SSH, two groups were created: Group M (00: 00h-05.59h, n = 253) and Group D (06: 00h - 23: 59h, n = 2602). Analyzing the impact of SSH on DS, ID, SC and AR. Evaluate the relationship between CIT (< 18h, 18-30h and > 30h) on ID, SC and AR utilizing univariate and multivariate statistical analysis with SPSS.
Results and Conclusion: Groups M and D were comparable in all evaluated demographic variables (p > 0.05), except cold ischemia time (Group M with higher CIT, p < 0.001). Regarding univariate analysis, Surgery start hour did not influence DS (p = 0.344), and SC (p = 0.264), but related with higher ID (p = 0.028) and AR (p = 0.018). CIT related with immediate diuresis (p = 0.020) and acute rejection (p < 0.001) but did not relate with complications (p = 0.734). Regarding multivariate analysis, SSH only influenced immediate diuresis (p = 0.026) and did not influenced acute rejection (p = 0.055). CIT influenced immediate diuresis (p = 0.019) and acute rejection (p < 0.001). Surgery start hour influences Immediate diuresis. With this study, we conclude that the priority must be a short cold ischemia time.

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How to Cite

Pereira Lourenço, M. ., Eliseu, M. ., Brito, D. V., Carvalho, J., Tavares-Silva, E., Marconi, L., Moreira, P. ., Nunes, P., Parada, B., Bastos, C., & Figueiredo, A. (2021). Early morning kidney transplantation: Perioperative complications. Archivio Italiano Di Urologia E Andrologia, 93(2), 158–161. https://doi.org/10.4081/aiua.2021.2.158

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