Urological Complications in 216 Human Recipients of Renal Transplants

Starzl, TE; Groth, Carl G.; Putnam, Charles W.; Penn, Israel; Halgrimson, Charles G.; Flatmark, A; L, Gecelter; Brettschneider, Lawrence; Stonington, Oliver G.

doi:10.1097/00000658-197007000-00001

Cited by 225 publications

(54 citation statements)

References 21 publications

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“…In our study, no patient died because of urologic complications, and we showed considerably good results (urinary leak rate was 2.5%, stenosis rate was 5%) compared with the literature (2.5%-25%). [12][13][14][15] Decreased blood supply to the donor ureter and faulty surgical techniques are the main causes of urologic complications; however, other problems, such as immunosuppressive drugs and rejections, can cause late obstruction. Although low-dose steroid protocols and meticulous operative techniques tend to reduce incidence or urologic complication, 10 poor ureteral vascularization owing to increased use of expanded criteria donors, especially older individuals, tend to increase this rate.…”

Section: Discussionmentioning

confidence: 99%

Surgical Complications After Pediatric Renal Transplant

Sozen

Fidan²,

Onur³

et al. 2019

Exp Clin Transplant

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Objectives: Renal transplant is the most appropriate treatment for both adult and pediatric patients with end-stage renal failure. Here, we analyzed surgical complications after pediatric renal transplant at our center. Materials and Methods:We retrospectively analyzed data from patient files and hospital charts of pediatric patients who had renal transplant at our center (Gazi University, Ankara, Turkey). Our immunosuppression protocol, a calcineurin inhibitor-based triple regimen, was applied to all recipients (steroids, mycophenolic acid). For neo-ureterocystostomy anastomosis, we used the corner-saving, open-loop continuous suture technique with double J stent for all patients, except when faced with an unfavorable situation. Catheters were removed within 4 weeks after transplant. Results: Among 40 pediatric renal transplant procedures performed at our center since 2006, we had 6 documented surgical complications (15%), with 3 being early and 3 being late complications. In the early transplant period, there were 2 surgical and 1 urologic complications. Eight patients (20%) lost their kidney grafts over the 10-year follow-up. The main reasons for graft loss were chronic allograft nephropathy in 4 patients (10%), BK virus nephropathy in 3 patients (7.5%), and hyperacute rejection in 1 patient (2.5%). Two patients died; however, no patient deaths or graft losses were from surgical complications. Overall graft and patient survival rates were 97% and 100% at 1 year, 94% and 98% at 5 years, and 68% and 95% at 10 years. Conclusions: Renal transplant in pediatric patients is a safe procedure in our department, based on patient and graft survivals, with a low rate of graft loss from surgical problems. As a result, our center is showing success with pediatric renal transplant procedures in accordance with the developed centers in the world.

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Section: Discussionmentioning

confidence: 99%

Surgical Complications After Pediatric Renal Transplant

Sozen

Fidan²,

Onur³

et al. 2019

Exp Clin Transplant

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“…Evolution to this technique has covered some 50 years of surgical progress. The ureteral anastomosis of kidney transplantation has historically been plagued by high complication rates, with early studies reporting mortality as high as 50% in those patients developing a urinary leak (1)(2)(3). Other commonly reported urinary complications include ureteral necrosis, stenosis and obstruction, clinically significant posttransplant hematuria, vesicoureteral reflux and infection (4,5).…”

Section: Introductionmentioning

confidence: 99%

Stented versus Nonstented Extravesical Ureteroneocystostomy in Renal Transplantation: A Metaanalysis

Mangus

Haag

2004

American Journal of Transplantation

191

113

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Stenting of the extravesical ureteroneocystostomy in renal transplantation is controversial. This study is a metaanalysis of 49 published studies over 30 years time in which the extravesical technique was used. Stented and nonstented anastomoses were compared. One-hundred six articles published between 1973 and 2002 were reviewed and 49 met criteria for inclusion. Articles were required to list original, numeric, previously unpublished data and to report or to describe the use of an extravesical ureteroneocystostomy, with or without stent. Data were analyzed within separate groups, (1) randomized, controlled trials and (2) case series. Data were included from five randomized, controlled trials and 44 case series. In the controlled trials group, there were urologic complications in 6 of 407 stented (1.5%), and 35 of 389 nonstented subjects (9.0%) (p < 0.0001, OR 0.24, 95% CI 0.10-0.57). In the case-series group, there were urologic complications in 137 of 4245 stented (3.2%) and 433 of 9077 nonstented subjects (4.8%) (p = 0.007, OR 0.58, 95% CI 0.39-0.86). Renal transplants with stented extravesical ureteroneocystostomy have a significantly lower urologic complication rate than those with nonstented anastomoses. All five randomized, controlled trials individually found stented anastomoses to have a lower complication rate and this was confirmed by metaanalysis of these trials and of case-series data.

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“…Recent incidence of urological complications is between 2.5% to 12.5% 13 , which is significantly lower than the 25% reported in the early days of renal transplantation. 14 There are many factors responsible for urological complications but the two most important factors are the blood supply of distal ureter and the technique of reimplantation. 15 The preservation of the blood supply of the distal ureter by careful preservation of the periureteric fat and the appropriate length of the ureter prevents the necrosis of distal ureter.…”

Section: Discussionmentioning

confidence: 99%

Surgical Complications of Live Related Renal Transplantation

Ashraf¹,

Seerwan²,

Ibrahim³

et al. 2016

Annals KEMU

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Introduction: Renal transplantation is the treatment of choice for patients with end stage renal disease. It offers marked improvement in the quality of life of patients who undergo this form of treatment. Surgical complications are important in the sense that they can lead to loss of allograft and in severe cases loss of patient life. The aim of this study is to determine the frequency of surgical complications after renal transplantation in our population. Materials and Methods:We retrospectively reviewed the surgical complications in 350 patients who had live related renal transplantation performed at Postgraduate Medical Institute, Shaikh

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Urological Complications in 216 Human Recipients of Renal Transplants

Cited by 225 publications

References 21 publications

Surgical Complications After Pediatric Renal Transplant

Surgical Complications After Pediatric Renal Transplant

Stented versus Nonstented Extravesical Ureteroneocystostomy in Renal Transplantation: A Metaanalysis

Surgical Complications of Live Related Renal Transplantation

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