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Complications of surgery

Kidney transplantation is not without complications. Complications can not only affect the transplanted kidney (graft) but also the whole body in general.

Surgical complications involving the graft

  • Bleeding
  • Wound infection
  • Obstruction to flow of urine
  • Fluid collection around the graft
  • Clotting of blood vessels of the graft
  • Urinary leak through the wound

Follow-up of the recipient after transplant

The recipient needs to come for follow-ups as per the following schedule; twice a week for 4 weeks, once a week for 3 months, once a fortnight for 6 months and once a month up to 2 years. Thereafter, once in 6 months for lifetime. These may be modified based on the patient needs by a nephrologist / transplant surgeon.

Medical complications involving the graft

  • Hyper acute rejection: can occur in the operation theatre itself, in-spite of all mandated precautions
  • Acute rejection: can occur from days to years after a successful transplant
  • Chronic rejection: can occur several months to years after a successful transplant

Some of the above conditions may necessitate re-surgery once or several times to try to save the graft. Sometimes it may become necessary to do a graft biopsy or even to remove the graft to save the patient's life. The patient may then have to go back on dialysis and plan either a second transplant or a life on dialysis.

Complications involving the rest of the body, mainly due to medications prescribed post surgery like cyclosporine, azathioprine, steroids, ATG, ALG, rituximab and tacrolimus

  • Infections like tuberculosis, pneumonia, brain infections, urinary infection, liver infections, etc. can occur. Some of these infections could be life threatening.
  • Hypertension (high B.P.)
  • Heart attack
  • Diabetes
  • Cancer due to immunosuppressive drugs
  • Loss of transplanted kidney due to BK virus infection