Ureteric complications of renal transplantation

• Published in: British journal of urology Vol. 70; no. 2; p. 139
• Main Authors: Kashi, S H, Lodge, J P, Giles, G R, Irving, H C
• Format: Journal Article
• Language: English
• Published: England 01.08.1992
• Subjects: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Graft Survival; Humans; Incidence; Kidney Transplantation; Male; Middle Aged; Necrosis; Nephrostomy, Percutaneous; Postoperative Complications; Stents; Ureter - pathology; Ureter - surgery; Ureteral Obstruction - etiology; Ureteral Obstruction - surgery
• ISSN: 0007-1331
• DOI: 10.1111/j.1464-410X.1992.tb15691.x

Of 507 consecutive recipients of renal allografts, 45 developed a urological complication. In 39 patients (7.7%) ureteric problems were implicated and these comprised 30 cases of obstruction and 9 cases of ureteric necrosis presenting as urinary leakage. In 7 patients ureteric obstruction resolved following a period of nephrostomy decompression; 10 patients were reconstructed surgically and this was successful in 8, with 2 patients requiring further surgical procedures. Ten patients were successfully treated by percutaneous stenting after dilatation of the stricture. Stenting failed in 4 patients and in 1 patient caused rupture of a calix. All 10 stents have now been removed and there is no recurrence of stricture (follow-up 32.0 +/- 8.6 months). Of the remaining 3 grafts, 2 were removed and the other graft had percutaneous removal of a ureteric calculus. The 1-year survival rate of allografts in the ureteric complication group was 84.6%; in the recipients without a urological complication it was 81%. It was concluded that an active approach to ureteric problems following renal transplantation results in the rescue of the majority of allografts.