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. 2024 Feb 1;42(1):65.
doi: 10.1007/s00345-023-04740-1.

Development and outcomes of surgical and urological kidney transplantation programs in Germany: a total population analysis from 2006 to 2021

Philipp Reimold  1 , Cem Aksoy  2 , Jonas Beckmann  2 , Aristeidis Zacharis  2 , Christer Groeben  2 , Philipp Karschuck  2 , Nicole Eisenmenger  3 , Josef Geks  4 , Johannes Huber  2 , Luka Flegar  2
Affiliations

Development and outcomes of surgical and urological kidney transplantation programs in Germany: a total population analysis from 2006 to 2021

Philipp Reimold et al. World J Urol. .

Abstract

Purpose: Kidney transplantation (KT) is the most frequently performed organ transplantation. In Germany, KT is performed in urology and surgery departments with unknown consequences of this parallel structure. The aim of the study was to compare the development and outcome of KT in urology and surgery departments.

Methods: On an institutional level, we analyzed the annual caseload from 2006 to 2021 with the reimbursement. INFO tool based on hospitals' quality reports (Reimbursement Institute, Hürth, Germany). For outcome comparison we extracted raw data from the transplantation centers' quality reports (Deutsche Stiftung Organtransplantation, DSO).

Results: A total of 23,599 cases (17,781 deceased donor and 5,818 living donor KTs) were included. The total number of KTs decreased from 1851 in 2006 to 1701 in 2021 (- 8%; p = 0.12). The total number of urological KTs decreased from 592 cases in 2006 to 395 cases in 2021 (- 33.3%; p = 0.01). Further analysis revealed no significant differences between intra- and postoperative complications and graft quality at one year for deceased donor KTs (DDKT) although differences in immediate renal function and graft quality at discharge could be observed. There were no significant differences in immediate renal function and graft quality at discharge for living donor KTs (LDKT) between the specialties.

Conclusion: KTs performed in urology departments declined between 2006 and 2021. Nevertheless, intra- and postoperative complications as well as long-term function did not differ between surgical and urological KT programs. Hence, an interdisciplinary approach, especially considering the upcoming challenges in KT as, e.g., robot-assisted surgery seems reasonable.

Keywords: Health services research; Kidney transplantation; Outcomes; Surgery; Urology.

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Conflict of interest statement

Mrs. Eisenmenger is founder and director of RI Innovation GmbH. J. Huber is Medical Board member of the “Urologische Stiftung Gesundheit gGmbH,” Chairman of the Working Group “Health Services Research, Quality and Economics” of the German Society of Urology e. V. and initiator of the “Entscheidungshilfe Prostatakrebs” (www.entscheidungshilfe-prostatakrebs.info). The latter is supported by Takeda Pharma, Janssen Cilag GmbH and APOGEPHA. He further indicates support of scientific projects outside the submitted work by Intuitive Surgical and Coloplast. All the other authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Departments of Surgery and Urology performing KTs in 2006 (left) and 2021 (right)
Fig. 2
Fig. 2
Kidney transplants in Germany from 2006 to 2021 based on the hospitals’ quality reports (extracted with the reimbursement.info tool)
Fig. 3
Fig. 3
Intra- and postoperative complications in deceased donor kidney transplants
See this image and copyright information in PMC

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