The urological complications of renal transplantation: a series of 1535 patients

• Published in: BJU international Vol. 90; no. 7; pp. 627 - 634
• Main Authors: Streeter, E.H., Little, D.M., Cranston, D.W., Morris, P.J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2002; Blackwell
• Subjects: Adolescent; Adult; aeti‐ology; Aged; Biological and medical sciences; Child; Combined surgery. Multiple transplantations; complications; Databases, Factual; Female; Hematuria - etiology; Humans; Kidney Calculi - etiology; Kidney Transplantation - adverse effects; Male; Medical sciences; Middle Aged; renal transplantation; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Donors; Ureteral Obstruction - etiology; Urinary Bladder Neck Obstruction - etiology; Urinary Bladder Neoplasms - etiology; Urologic Diseases - etiology; Human; Etiology; Surgery; Risk factor; Complication; Transplantation; Urinary tract disease; Urinary tract; Homotransplantation; Kidney; Incidence
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1046/j.1464-410X.2002.03004.x

Objective  To determine the incidence of urological complications of renal transplantation at one institution, and relate this to donor and recipient factors. Patients and methods  A consecutive series of 1535 renal transplants were audited, and a database of donor and recipient characteristics created for risk‐factor analysis. An unstented Leadbetter‐Politano anastomosis was the preferred method of ureteric reimplantation. Results  There were 45 urinary leaks, 54 primary ureteric obstructions, nine cases of ureteric calculi, three bladder stones and 19 cases of bladder outlet obstruction at some time after transplantation. The overall incidence of urological complications was 9.2%, with that for urinary leak or primary ureteric obstruction being 6.5%. One graft was lost because of complications, and there were three deaths associated directly or indirectly with urological complications. There was no association with recipient age, cadaveric vs living‐donor transplants, or cold ischaemic times before organ reimplantation, although the donor age was slightly higher in cases of urinary leak. There was no association with kidneys imported via the UK national organ‐sharing scheme vs the use of local kidneys. The management of these complications is discussed. Conclusion  The incidence of urological complications in this series has remained essentially unchanged for 20 years. The causes of these complications and techniques for their prevention are discussed.