Analysis of late operations in transplant patients

Objective. The charts of 174 consecutive patients were analyzed for incidence, etiology, and outcome of late operations (1 month or more posttransplant) following liver (OLT), kidney (KT), or pancreas-kidney (SPK) transplantation. Materials and Methods. Clinical and demographic data were analyzed by chi-square analysis and Fisher exact tests to compare subpopulations. All P values <.05 were considered statistically significant. Results. Censured data revealed 155 patients who did not suffer death or organ loss within 30 days of transplant. Late operations were performed on 89 occasions in 57 patients (65% occurred within 1 year posttransplant) with 20 patients having two or more late operations. Of these 89 procedures, 40% were emergent, 37% were related to the transplant operation, 38% were related to the initial disease, and 73% were major interventions. Fifty-six procedures were performed by the transplant surgery team and all occurred in the same facility as the transplant. Conclusions. Transplant recipients have a high incidence (36%) of late operations, most within the first year and most related to either the transplant or the original disease. This heavy operative load is important in planning resource allocation. Oversight by and involvement of the transplantation service in these procedures may contribute to the favorable outcome of these operations.