Early surgical complications following kidney transplantation in adults: A systematic review.
Ortved, M., et al.Transplant Rev (Orlando). 2025 Dec;39(4):100963.
Aims
This study aimed to investigate the rate, risk factors and types of early surgical complication in adult kidney transplant recipients.
Interventions
Database search was performed using Medline, PubMed and Embase. Title, abstracts and full-text were screened by two independent authors. Data was extracted independently by the primary author and partially reviewed by a second author. The methodological quality was assessed using the Newcastle-Ottawa Scale (NOS).
Participants
30 studies were included in the review.
Outcomes
Primary outcome: Overall complication rate. Secondary outcomes: Reoperation rate, major complication rate, rate of graded complications, type of complication frequency, mortality rate, graft loss, length of stay, incidence of delayed graft function.
Follow-up
N/A
CET Conclusions
Surgical complications following kidney transplantation (KT) have been extensively reported in the literature, but using various definitions and timepoints. This systematic review attempted to determine the rate of post-operative complications at 30 and 90 days of KT. The primary outcome was the overall rate of post-operative complications. Secondary outcomes included, inter alia, the rate of major complications and frequency of specific complications. 30 studies (n=19650) were included in the analysis. The overall rate of complication at 30 and 90 days were 41% and 36% respectively, while the rate of major complications were 19% and 24% respectively. The rates of specific complications (e.g. arterial thrombosis, wound infection etc.) were broadly similar to that reported in individual studies. A meta-analysis of risk factors that could predict post-operative complications was not done, but individual study results were presented. Interestingly, expected risk factors including patient age, BMI, cold-ischaemic time and high co-morbidity scores were not associated with a higher rate of major complications in most of the included studies. It may be the case that these risk factors do increase the rate of minor complications but not that of major complications – an important consideration in the risk assessment of the potential KT recipient.
Trial registration
PROSPERO - CRD42024535328