An analysis of unplanned return to the operating room following deceased donor kidney transplantation.

Introduction: This study was undertaken to characterize unplanned return to the OR following kidney transplantation(KT).

Methods: All patients undergoing KT at a single center from 1/2015 through 11/2017 were evaluated. The primary endpoint was unplanned return to the OR within 90 days. Perioperative and one year patient and graft outcomes were also determined.

Results: Of 190 patients, 14(7.4%) of patients had unplanned reoperation. The most common individual indications were bleeding from biopsy sites(n = 2), poor vascular flow on postop ultrasound(n = 4), and perforated diverticulitis(n = 2). Forty Three percent of all reoperations were unrelated to the technical conduct of the transplant operation. Reoperated patients had significantly worse survival at one year(78.6% vs. 96.6%), although graft function in survivors was similar to those who did not return to the OR.

Conclusion: Reoperation following KT is frequently unrelated to the technical conduct of the transplant procedure, thus it may not be useful as a quality metric.