Renal transplantation is one of the most significant advances in the scientific progress of modern medicine, however, the increase in survival is the main therapeutic challenge. In spite of the innovations in immunological study and immunosuppressive treatment, a situation that is not yet achieved, so we propose a review of complications in order to evaluate weak points for strengthening
Objective: to evaluate the medical complications of post-operated transplant patients.
Material and Methods: In a retrospective cohort of post-transplant kidney patients of the last 3 years with the evaluation of all the medical complications (infectious and metabolic) that they presented throughout the year.
Results: A total of 246 records reviewed, average age 26 years. 130 men (52.8%) and 116 women (47.2%). By reactive panel of antibodies the 9.8 had high (> 30%), and 28 patients (11.4%) were detected antibodies against specific donors.
The total of infectious complications throughout the year was 138 cases of which 46.3% was from urinary tract infections, followed by 32 cases of lower respiratory tract infections. 7 cases of BK virus nephropathy. 6.1% (15 cases) of tuberculosis.
Of the metabolic complications. The most frequent was weight alteration in 127 cases (51.6%). Diabetes mellitus occurred in 6.1% of the population, dyslipidemia 40.7% and hyperuricemia 41.5%. The persistence of bone mineral metabolism alterations were present in 39.4% (97 patients).
Creatinine levels at discharge of the transplant had a mean of 1.2 with SD ± 0.51, a year of 1.5 with SD ± 1.51, the average of creatinine clearance at discharge of 74.5 with SD ± 24 and a year of 63 with SD ± 24.66. The proteinuria in 24-hour urine was significant in 30 patients (12.2 cases). The rejection charts documented by renal graft biopsy were 27 cases (11%), report of humoral rejection in 11 cases (4.5%), cell type in 14 patients (5.7%) and mixed in 4 cases (1.6%). Acute graft dysfunction 111 (45.1) of all patients Defined by creatinine elevation greater than 0.3% and / or decreased urinary volumes according to the AKIN classification of acute kidney injury.
Conclusions: Despite multiple efforts and advances in the field of immunosuppression and prophylactic treatments; infectious bacterial and viral complications continue to be a frequent cause of mortality; involving the urinary tract mainly taking surgical manipulation as a risk factor; and being more frequent in the first months of the transplant. It should be noted that other metabolic complications contribute to the mortality of transplant patients such as diabetes mellitus, hyperuricemia, dyslipidemia and obesity.