Native ureteropyelostomy in the treatment of obstructive uropathy in adult renal transplant. Experience and technical alternatives

Trilla, E.; Lorenté, David; Salvador, C.; Planas, Jacques; Placer, J.; Celma, A.; Cantarell, C.; Moreso, Francesc; Serón, Daniel; Moróte, Juan

doi:10.1016/j.acuroe.2014.07.004

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Similar to the findings of other investigators , we also found that the graft survival was not significantly different for those with urologic complications compared to those without. The comparable outcomes of recipients with urologic complications may be due to the availability of various surgical options for treatment of those complications such as ureteroureterostomy or ureteropyelostomy .…”

Section: Discussionmentioning

confidence: 99%

Independent risk factors for early urologic complications after kidney transplantation

Rahnemai‐Azar

Gilchrist

Kayler

2015

Clinical Transplantation

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Urologic complications are the most frequent technical adverse events following kidney transplantation (KTX). We evaluated traditional and novel potential risk factors for urologic complications following KTX. Consecutive KTX recipients between December 1, 2006 and December 31, 2010 with at least six-month follow-up (n = 635) were evaluated for overall urologic complications accounting for donor, recipient, and transplant characteristics using univariate and multivariate logistic regression. Urologic complications occurred in 29 cases (4.6%) at a median of 40 d (range 1-999) post-transplantation and included 17 ureteral strictures (2.6%), five (0.8%) ureteral obstructions due to donor-derived stones or intraluminal thrombus, and seven urine leaks (1.1%). All except two complications occurred within the first year of transplantation. Risk factors for urologic complications on univariate analysis were dual KTX (p = 0.04) and renal artery multiplicity (p = 0.02). On multivariate analysis, only renal artery multiplicity remained significant (aHR 2.4, 95% confidence interval 1.1, 5.1, p = 0.02). Donation after cardiac death, non-mandatory national share kidneys, donor peak serum creatinine > 1.5 mg/dL or creatinine phosphokinase > 1000 IU/L, and donor down time were not associated with urologic complications. Our data suggest that donor artery multiplicity is an independent risk factor for urologic complications following KTX.

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Section: Discussionmentioning

confidence: 99%

Independent risk factors for early urologic complications after kidney transplantation

Rahnemai‐Azar

Gilchrist

Kayler

2015

Clinical Transplantation

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“…Yag laser endoureterotomy can be used safely and successfully in patients with posttransplant ureterovesical strictures (3). There are some reports indicating that native ureteropyelostomy can effectively be used in posttransplant strictures (14,15). We successfully performed ureteroureterostomy for uretheral stenosis.…”

Section: Discussionmentioning

confidence: 92%

Surgical Treatment for Ureteral Complications Following Renal Transplantations

Uysal¹,

Yüzbaşıoğlu²,

Dokur³

et al. 2015

jus

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What's known on the subject? and What does the study add? ÖZET Amaç Üreter darlığı ve nekrozu renal transplantasyon sonrası en sık görülen ürolojik komplikasyonlardır. Darlıkların tedavisinde cerrahi, perkütan girişimsel yaklaşımlar, laser endoüreterotomi gibi yöntemler uygulanabilir. Üreter nekrozlarında cerrahi tedavi ön planda yer almaktadır. Çalışmamızda merkezimizde yapılan renal transplantasyon sonrası görülen üreter komplikasyonlarının nedenlerini incelemek ve uygulanan cerrahi tedavi seçeneklerini değerlendirmek amaçlanmıştır. gereç ve yöntem 2011 ve 2014 yılları arasında transplantasyon merkezimizde yapılan 160 kadavra ve canlı renal transplantasyon kayıtları retrospektif olarak değerlendirmeye alındı. Ürolojik komplikasyon nedeniyle cerrahi müdahele uygulanan 10 hastanın demografik özellikleri, gelişen komplikasyon türü, ürolojik komplikasyona uygulanan cerrahi yöntemler ve sonuçları kayıt edildi. Hastaların verilerine dosya taramaları ile ulaşıldı. Bulgular Üreter darlığı 6 hastada (%3,75), üreter nekrozu 4 hastada (%2,5) görüldü. Transplantasyonların 3'ü canlı donörden (2 kadın, 1 erkek), 7'si kadavradan (1 kadın, 6 erkek) yapıldı. İdrar kaçağı üreter nekrozundan dolayı, 4 hastada görüldü. Kaçak oluşan hastalarda kaçaklar yaklaşık 2. haftada görüldü. Üreter nekrozu nedeniyle 2 hastaya native üreteropyelostomi, diğer 2 hastaya üreteroneosistostomi uygulandı. Üreter stenozu için bir hastaya üreteroüreterostomi, 4 hastaya üreteroneosistostomi, bir hastaya native ürteropyelostomi uygulandı. Native üreteropyelostomi uygulanan hastada idrar kaçağı görüldü. Sonuç Çalışmamızda renal transplantasyon sonrası ürolojik komplikasyonlar en sık kadavra transplantasyonlar sonrası görüldü. Üreter stenozu en sık görülen komplikasyondu. Üriner sistem enfeksiyonları üreter Objective Ureteral stenosis and necrosis are the most common urological complications after a renal transplantation. Surgery is the treatment of choice in ureteral necrosis, whereas surgery, percutaneous approaches and laser endoureteromy may be applied in ureteral stenosis. The aim of this study was to review the causes of and surgical treatment methods for ureteral complications following renal transplantations. Materials and Methods One hundred sixty renal transplantations were performed from both cadaveric and live donors at our transplantation center between 2011 and 2014. Demographic features, complication types, surgical methods and the treatment results in 10 patients, who required surgical intervention due to ureteral complications, were recorded. Data was collected retrospectively through patient charts. Results Patients who were operated on because of ureteral complications were enrolled in the study. Six patients (3.75%) had ureteral stenosis, and 4 patients (2.5%) had ureteral necrosis. Three of these transplantations were made from living donors (2 female and 1 male) and 7 were from cadavers (1 female and 6 male). Extravasation was found in 4 patients due to necrosis, all encountered in the second week of operation. Two patients underwent...

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Native ureteropyelostomy in the treatment of obstructive uropathy in adult renal transplant. Experience and technical alternatives

Cited by 2 publications

References 17 publications

Independent risk factors for early urologic complications after kidney transplantation

Independent risk factors for early urologic complications after kidney transplantation

Surgical Treatment for Ureteral Complications Following Renal Transplantations

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