Urological Complications and Vesicoureteral Reflux Following Pediatric Kidney Transplantation

Routh, Jonathan C.; Yu, Richard N.; Kozinn, Spencer; Nguyen, Hiep T.; Borer, Joseph G.

doi:10.1016/j.juro.2012.09.091

Cited by 39 publications

(53 citation statements)

References 17 publications

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“…Vesicoureteral reflux and urinary fistula have also been reported [3, 4]. A study of 206 pediatric recipients found obstruction and/or urinary extravasation in 7.6%, reflux in 10.6%, and graft loss in 17% of patients [5]. These complications have traditionally been managed with open surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

The Current Role of Endourologic Management of Renal Transplantation Complications

Duty

Conlin

Fuchs

et al. 2013

Advances in Urology

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Introduction. Complications following renal transplantation include ureteral obstruction, urinary leak and fistula, urinary retention, urolithiasis, and vesicoureteral reflux. These complications have traditionally been managed with open surgical correction, but minimally invasive techniques are being utilized frequently. Materials and Methods. A literature review was performed on the use of endourologic techniques for the management of urologic transplant complications. Results. Ureterovesical anastomotic stricture is the most common long-term urologic complication following renal transplantation. Direct vision endoureterotomy is successful in up to 79% of cases. Urinary leak is the most frequent renal transplant complication early in the postoperative period. Up to 62% of patients have been successfully treated with maximal decompression (nephrostomy tube, ureteral stent, and Foley catheter). Excellent outcomes have been reported following transurethral resection of the prostate shortly after transplantation for patients with urinary retention. Vesicoureteral reflux after renal transplant is common. Deflux injection has been shown to resolve reflux in up to 90% of patients with low-grade disease in the absence of high pressure voiding. Donor-gifted and de novo transplant calculi may be managed with shock wave, ureteroscopic, or percutaneous lithotripsy. Conclusions. Recent advances in equipment and technique have allowed many transplant patients with complications to be effectively managed endoscopically.

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Section: Introductionmentioning

confidence: 99%

The Current Role of Endourologic Management of Renal Transplantation Complications

Duty

Conlin

Fuchs

et al. 2013

Advances in Urology

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“…20 The reported incidence of VUR ranges from 3.0% to 12.4%, although notably several of these studies involved the pediatric population. [25][26][27][28] In a single institution study of 2500 transplants over a 16-year period by a single transplant urologist, symptomatic VUR was reported in 3% (78 patients). 21 The average time to presentation was 3.5 years (0.5-15 y), and the most common presentation was recurrent UTI.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Sui

Lipsky²,

Matulay³

et al. 2018

Exp Clin Transplant

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Objectives: The most common complications after renal transplant are urologic and are a cause of significant morbidity in a vulnerable population. We sought to characterize the timing and predictors of urologic complications after renal transplant using a statewide database. Results: In total, 9038 patients were included in the analyses. Urologic complications occurred in 11.3% of patients and included hydronephrosis (12.0%), nephrolithiasis (2.8%), ureteral stricture (2.4%), and vesicoureteral reflux (1.5%). We found that 23% experienced at least one urinary tract infection. On multivariate analysis, predictors of urologic complications included medicare insurance, hypertension, and prior urinary tract infection. Graft recipients from living donors were less likely to experience urologic complications than deceased-donor kidney recipients (P < .001). Conclusions: Urologic complications occur in a significant proportion of renal transplants. Further study is needed to identify risk factors for complications after renal transplantation to decrease morbidity in this vulnerable population.

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“…Not used risk for postoperative vesico-ureteral reflux problems even after surgical repair (11,12). Pediatric post-transplant hydronephrosis has correlated with worsening renal function and increased incidence of pyelonephritis, necessitating more aggressive preoperative and postoperative urologic testing and management (13).…”

Section: Not Usedmentioning

confidence: 99%

Renal Relevant Radiology

Sharfuddin

2014

Clinical Journal of the American Society of Nephrology

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SummaryKidney transplantation can be associated with various complications that vary from vascular complications to urologic disorders to immunologic adverse effects. In evaluating the recipient with graft dysfunction, clinicians can choose among several imaging modalities, including ultrasonography, nuclear medicine studies, computed tomography, and magnetic resonance imaging. This review discusses the evaluation of the kidney transplant recipient using these imaging procedures, emphasizing the clinical diagnostic utility and role of each modality. A kidney biopsy is often required as a gold standard for diagnostic purposes. However, because of the inherent risks of a kidney biopsy, noninvasive imaging in diagnosing causes of graft dysfunction is a highly desired tool used and needed by the transplant community. Because the diagnostic accuracy varies depending on the time course and nature of the transplant-related complication, this review also addresses the advantages and limitations of each modality. The recent advances in kidney transplant imaging techniques and their clinical implications are also discussed.

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Urological Complications and Vesicoureteral Reflux Following Pediatric Kidney Transplantation

Cited by 39 publications

References 17 publications

The Current Role of Endourologic Management of Renal Transplantation Complications

The Current Role of Endourologic Management of Renal Transplantation Complications

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Renal Relevant Radiology

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