Introduction: As long-term outcomes after kidney transplantation significantly improve, the frequency of kidney transplant recipients who require nontransplant surgery is increased. Perioperative and postoperative management of transplant recipients are not different from general population. However, transplant recipients have higher risk of new cardiovascular adverse events, infections and wound healing complications after surgeries. Our aim is to assess outcomes of renal transplant recipients who undergo non-oncological abdominal surgery not associated with transplantation.
Methods: This is a retrospective cohort study. We retrospectively evaluated 1325 adult patients who underwent kidney transplantation between 01/01/2005 and 31/12/2020 in Ege University School of Medicine. Among those, 59 kidney transplant recipients who underwent non-oncological abdominal surgery not associated with transplantation until 31/12/2023 were included. We retrospectively evaluated clinical and surgical findings and outcomes from electronic patient management system.
Results: A total of 62 abdominal surgery operations were performed on 59 transplant recipients included in the study. Mean age was 45.7±12.0 years and 41.9% was female. Most of the patients (59.7%) were transplanted from a living donor. Mean time from kidney transplantation operation to abdominal surgery was 5.7±3.9 years. The most frequently performed surgeries were cholecystectomy (48.4%), hernia repair (27.4%), appendectomy (4.8%) and bridectomy (4.8%) respectively. A total of 51 surgeries (86%) were elective procedures. Mean hospitalization duration after abdominal surgery was 8.8±9.7 days. No graft or patient loss was observed after the surgery and during the follow-up period.  
Conclusion: In kidney transplant recipients, the most common non-oncological abdominal surgeries not associated with transplantation were cholecystectomy, hernia repair, appendectomy and bridectomy. Such surgeries appear safe in this special population with high morbidity risk.