Early urological complications after kidney transplantation: An overview

Abstract

Urological complications, especially urine leaks, remain the most common type of surgical complication in the early post-transplant period. Despite major advances in the field of transplantation, a small minority of kidney transplants are still being lost due to urological problems. Many of these complications can be traced back to the time of retrieval and implantation. Serial ultrasound examination of the transplanted graft in the early post-operative period is of key importance for early detection. The prognosis is generally excellent if recognized and managed in a timely fashion. The purpose of this narrative review is to discuss the different presentations, compare various ureterovesical anastomosis techniques and provide a basic overview for the management of post-transplant urological complications.

Frailty predicts surgical complications after kidney transplantation. A propensity score matched study

“…Until the present study, no studies evaluating the frailty score as a specific predictor of surgical complications after KTx have been identified. In general, the frequency of urological, vascular, and general surgical complications in the studied sample was in agreement with the literature [3,4,[6][7][8][9][10]. Urinary leak was the most frequent complication, accounting for 8.0% of the total.…”

“…Although several classifications have been proposed, surgical complications can typically be divided into urological and vascular complications. The most common urological complications, usually present in up to 15% of patients, are urinary leak, ureteral obstruction/stricture, lithiasis, and vesicoureteral reflux, whose treatments will depend on the time of onset and severity of the condition, among other variables [4,6,7]. In turn, vascular complications, observed in 3 to 15% of cases, tend to have less favorable outcomes.…”

Effectiveness of Factor XIII Infusion in Treatment of Refractory Ureteral Leakage after Kidney Transplantation

“…These mainly involve leakage from the ureter, resulting in the formation of urinomas. This complication causes abdominal pain, swelling of the transplant site, elevated serum creatinine level, oliguria, and/or signs of systemic infection [1]. Urine leakage usually occurs from the distal regions of the ureter in the early posttransplantation period (7-10 days), and its incidence rate ranges from approximately 1.5 to 6.0% [1].…”

“…This complication causes abdominal pain, swelling of the transplant site, elevated serum creatinine level, oliguria, and/or signs of systemic infection [1]. Urine leakage usually occurs from the distal regions of the ureter in the early posttransplantation period (7-10 days), and its incidence rate ranges from approximately 1.5 to 6.0% [1]. Although native ureters receive blood supply from both renal arteries and collaterals, the graft ureter only depends on the arterial and venous supply from the renal vessels and lower polar branches.…”

“…Urological complications after kidney transplantation are common and could lead to severe urinary tract infections or even early loss of renal graft [1]. Generally, periureteral tissues contain feeding vessels, and overdissecting the tissues around the ureter could cause necrosis, leading to ureteral leakage [2].…”