Objective  To explore factors affecting the postoperative renal function and surgical complications in recipients of living donor kidney transplantation.

Methods  A retrospective analysis was conducted on medical records of 119 patients who underwent living donor kidney transplantation at Beijing Friendship Hospital Affiliated to Capital Medical University, from January 2020 to September 2024. The severity of surgical complications was evaluated using the Clavien-Dindo score. Spearman correlation analysis was used to analyze the correlation between preoperative general data, surgical data, preoperative laboratory data and the Clavien-Dindo score. Multiple linear regression analysis was performed on the correlated factors. Univariate and multivariate logistic regression analyses were used to analyze the factors affecting the occurrence of delayed graft function (DGF) after surgery.

Results  The body mass index, history of hypertension, cold ischemia time, the first warm ischemia time, the second warm ischemia time, prothrombin activity and international normalized ratio were all correlated with the Clavien-Dindo score. Multiple linear regression analysis showed that the longer the second warm ischemia time and the first warm ischemia time were, the higher the Clavien-Dindo score was, and the more severe the postoperative surgical complications were (all P<0.05). Multivariate logistic regression analysis showed that long the first warm ischemia time and long dialysis time were independent risk factors for the occurrence of DGF after surgery (all P<0.05).

Conclusions  Prolonged the second warm ischemia time and the first warm ischemia time may increase the severity of surgical complications in recipients after living donor kidney transplantation. Long the first warm ischemia time and long dialysis time are independent risk factors for the occurrence of DGF after surgery.