TY  - JOUR
A1  - Wenzel, Mike
A1  - Würnschimmel, Christoph
A1  - Chierigo, Francesco
A1  - Tian, Zhe
A1  - Shariat, Shahrokh F.
A1  - Terrone, Carlo
A1  - Saad, Fred
A1  - Tilki, Derya
A1  - Graefen, Markus
A1  - Banek, Séverine
A1  - Kluth, Luis
A1  - Mandel, Philipp
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Increased risk of postoperative in-hospital complications after radical prostatectomy in patients with prior organ transplant
T2  - The prostate
N2  - Background: To analyze postoperative, in-hospital, complication rates in patients with organ transplantation before radical prostatectomy (RP). Methods: From National Inpatient Sample (NIS) database (2000–2015) prostate cancer patients treated with RP were abstracted and stratified according to prior organ transplant versus nontransplant. Multivariable logistic regression models predicted in-hospital complications. Results: Of all eligible 202,419 RP patients, 216 (0.1%) underwent RP after prior organ transplantation. Transplant RP patients exhibited higher proportions of Charlson comorbidity index ≥2 (13.0% vs. 3.0%), obesity (9.3% vs. 5.6%, both p < 0.05), versus to nontransplant RP. Of transplant RP patients, 96 underwent kidney (44.4%), 44 heart (20.4%), 40 liver (18.5%), 30 (13.9%) bone marrow, <11 lung (<5%), and <11 pancreatic (<5%) transplantation before RP. Within transplant RP patients, rates of lymph node dissection ranged from 37.5% (kidney transplant) to 60.0% (bone marrow transplant, p < 0.01) versus 51% in nontransplant patients. Regarding in-hospital complications, transplant patients more frequently exhibited, diabetic (31.5% vs. 11.6%, p < 0.001), major (7.9% vs. 2.9%) cardiac complications (3.2% vs. 1.2%, p = 0.01), and acute kidney failure (5.1% vs. 0.9%, p < 0.001), versus nontransplant RP. In multivariable logistic regression models, transplant RP patients were at higher risk of acute kidney failure (odds ratio [OR]: 4.83), diabetic (OR: 2.81), major (OR: 2.39), intraoperative (OR: 2.38), cardiac (OR: 2.16), transfusion (OR: 1.37), and overall complications (1.36, all p < 0.001). No in-hospital mortalities were recorded in transplant patients after RP. Conclusions: Of all transplants before RP, kidney ranks first. RP patients with prior transplantation have an increased risk of in-hospital complications. The highest risk, relative to nontransplant RP patients appears to acute kidney failure.
KW  - bone barrow
KW  - heart
KW  - kidney
KW  - liver
KW  - surgical complications
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/64411
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-644110
SN  - 1097-0045
N1  - The research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Open Access funding enabled and organized by Projekt DEAL.
VL  - 81
IS  - 16
SP  - 1294
EP  - 1302
PB  - Wiley-Liss
CY  - New York, NY
ER  -