Open AccessPostoperative surgical‐site hemorrhage after kidney transplantation: incidence, risk factors, and outcomes
Author(s) -
Hachem Laureen D.,
Ghanekar Anand,
Selzner Markus,
Famure Olusegun,
Li Yanhong,
Kim Sang Joseph
Publication year - 2017
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12926
Subject(s) - medicine , surgery , incidence (geometry) , kidney transplantation , transplantation , risk factor , hematoma , physics , optics
Summary 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/m 2 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.