Abstract
Objective: To present the main complications found in patients subjected to kidney transplantation. Bibliographic review: Kidney transplant is associated with a reduction in cardiovascular risk and mortality, in addition to resulting in a better life quality for the patient. The transplant is reserved for patients with Chronic Kidney Disease (CKD) stage 5, being dialytic or terminal, thus being a replacement renal therapy as they will continue to have CKD due to Glomerular filtration rate (GFR) < 60ml/min/1.73m2. The most common complications are due to bacterial and viral infections, which can lead to re-hospitalization and graft loss in the first year. The complications can also be immunological due to the necessity of human leukocyte antigen (HLA) antibody compatibility between the donor and receptor, also being related to the durability of the transplant. The prognosis can be complicated by pre-existing cardiovascular disease and metabolic syndromes. Regarding surgical complications, there are the urological and vascular problems. Final considerations: It is proven that the transplant can change the natural course of the disease, reducing mortality and improving the prognosis of patients. Considering that, encouraging kidney donation and transplantation is essential.
References
AGRAWAL A, et al. Long-Term Infectious Complications of Kidney Transplantation. Clinical Journal of the American Society of Nephrology, 2021; 17(2): 286-295.
AGUILERA PM, et al. The Sum of Kidney Donor Profile Index and Estimated Post-Transplant Survival Scale and Their Correlation with eGFR Decline in Deceased Donor Kidney Recipients. Revista de Investigación Clínica, 2021; 73(4): 2016-221.
ALVES EBS, et al. Principais causas da rejeição de rim em pacientes transplantados. Revista de Enfermagem UFPI, 2019; 8(3): 78-82.
AUGUSTINE J. Kidney transplant: New opportunities and challenges. Cleveland Clinic Journal of Medicine, 2018; 85(2):138-144.
CALLEMEYN J, et al. Allorecognition and the spectrum of kidney transplant rejection. Kidney International, 2022; 101: 692–710.
CARMINATTI M, et al. Chronic kidney disease progression in kidney transplant recipients. Nephrology, 2019; 24(2): 141-147.
COHEN E, et al. Metabolic Disorders with Kidney Transplant. Clinical Journal of the American Society of Nephrology, 2020; 15(5): 732-742.
DEKKER WK, et al. Predictors of postoperative cardiovascular complications up to 3 months after kidney transplantation. Netherlands Heart Journal, 2020; 28 (4): 202-209.
ECKER R, et al. Mortalidade pós transplante renal. Revista Interdisciplinar de Estudos em Saúde UNIARP, 2019; 18(2): 253-260.
EVANS M, et al. A Narrative Review of Chronic Kidney Disease in Clinical Practice: Current Challenges and Future Perspectives. Adv Ther, 2022; 39(1):33-43.
FISHMAN JA. Infection in Organ Transplantation. American Journal of Transplantation, 2017; 17(4): 856-879.
GILL J, et al. The risk of allograft failure and the survival benefit of kidney transplantation are complicated by delayed graft function. Kidney International, 2016; 6: 1331-1336.
HABERAL M, et al. Surgical Complications After Kidney Transplantation. Experimental and Clinical Transplantation, 2016; 6:587- 595.
JHA V, et al. Chronic kidney disease: global dimension and perspectives. The Lancet, 2020; 382 (9888): 260-272.
KDIGO. Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int 2022; 98: S1-S115.
NETO JAM, et al. Fifty years of the first transplant in Brazil. JBT J Bras Transplante, 2016; 19(4):1-155.
PINTO H, et al. Surgical Complications in Early Post-transplant Kidney Recipients. Transplantation Proceedings, 2017; 49: 821e823.
RAO NN, et al. Cardiovascular Disease After Kidney Transplant. Seminars in Nephrology, 2018; 38(3): 291-297.
ROSE C, et al. Association of Kidney Transplantation with Survival in Patients with Long Dialysis Exposure. Clinical Journal of the American Society of Nephrology, 2017; 12: 2024–2031.
SAAD EJ, et al. Infections in the first year after renal transplant. Medicina Buenos Aires, 2020; 80: 611-621.
SANTOS FMR, et al. Prevalência e fatores associados a não inscrição para transplante renal. Cadernos de Saúde Pública, 2021; 37(6): e00043620.
SARAIVA LC, et al. Caracterização clínica de pessoas submetidas a transplante renal: sensibilização imunológica. Revista de Enfermagem Referência, 2021; 5(6): e20121.
SASS DA, DOYLE AM. Liver and Kidney Transplantation. Medical Clinics of North America, 2016; 100(3): 435-448.
TAVARES MG, et al. Readmissão Hospitalar Precoce no transplante renal: artigo de revisão. Jornal Brasileiro de Nefrologia, 2020; 42(2): 231-237.
UYAR B. The analysis of immunosuppressant therapy adherence, depression, anxiety, and stress in kidney transplant recipients in the post-transplantation period. Transplant Immunology, 2022; 75: e101686.
WOOD EL, et al. Clinical outcomes and complications of recipients of HLA matched living donor kidney transplants at UCLA: A retrospective chart review. Transplantation Reports, 2022; 7(3): e100101.
