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. 2017 May;30(5):474-483.
doi: 10.1111/tri.12926. Epub 2017 Mar 2.

Postoperative surgical-site hemorrhage after kidney transplantation: incidence, risk factors, and outcomes

Laureen D Hachem  1 , Anand Ghanekar  1   2 , Markus Selzner  1   2 , Olusegun Famure  1   3 , Yanhong Li  1 , Sang Joseph Kim  1   3   4
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Free article

Postoperative surgical-site hemorrhage after kidney transplantation: incidence, risk factors, and outcomes

Laureen D Hachem et al. Transpl Int. 2017 May.
Free article

Abstract

Studies investigating the incidence, risk factors, and outcomes of surgical-site hemorrhage after kidney transplantation are limited. Patients who underwent a kidney transplant from 1 January 2000 to 30 September 2012 (followed until 31 December 2012) at Toronto General Hospital were included in this study. Postoperative surgical-site hemorrhage was defined as a drop in hemoglobin ≥20 g/l over a 24-hour period within 3 days of transplantation, followed by an ultrasound indicating a significant hematoma/collection. A total of 59 of 1203 (4.9%) kidney transplant recipients had postoperative surgical-site hemorrhage. Most cases (89.8%) occurred within 1 day after transplantation. Living donor transplants [OR 0.30 (95% CI: 0.16, 0.55)] and higher recipient BMI [OR 0.54 per 10 kg/m2 increase in BMI (95% CI: 0.30, 0.99)] were associated with a significantly lower risk of bleeding. Chronic preoperative anticoagulant usage led to an increased risk of bleeding but was not statistically significant [OR 1.75 (95% CI: 0.52, 5.88)]. Postoperative hemorrhage was associated with a higher risk of graft loss or death [HR 1.62 (95% CI: 1.01, 2.60)]. While the incidence of postoperative surgical-site hemorrhage in kidney transplantation is relatively low, it may be associated with an increased risk of graft loss or death.

Keywords: incidence; kidney transplant; outcomes; risk factors; surgical-site hemorrhage.

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