Late Ureteral Stenosis Following Renal Transplantation: Risk Factors and Impact on Patient and Graft Survival

Abstract

The aim of this retrospective study of a cohort of 1787 consecutive kidney transplantations was to analyze the risk factors associated with the occurrence of ureteral stenosis and the impact of ureteral stenosis on graft and patient survival. Between January 1990 and December 2002, 1787 renal transplantations were performed at our center. Only stenosis observed after the first month, were considered. Among the parameters studied were: donor age and serum creatinine before procurement; recipient age, cold ischemia time, delayed graft function (DGF), number of arteries and the presence of a double J stent. The follow-up parameters were the number and timing of acute rejection episodes, cytomegalovirus (CMV) infection, acute pyelonephritis, renal function and death. Ureteral stenosis occurred in 4.1% of patients and was correlated with donor age > 65 years (p = 0.001), kidneys with more than 2 arteries (p = 0.009) and DGF (p = 0.016). Ureteral stenosis did not affect 10-year patient and graft survival rates, which were respectively 90% and 64% for the stenosis group, 86% and 63% for the no-stenosis group (p = NS). These data suggest an important role for donor age, number of renal arteries and DGF for the occurrence of ureteral stenosis following renal transplantation.

Ureteral Stenosis of Transplanted Kidney

“…The mentioned study by the authors Streeter et al confirm the significant difference between the donor´s age of the patients with ureteral stenosis and the donor´s age of the recipients in which no ureteral stenosis was developed (P < 0.05) (1). In another study by the authors Karam et al with more than 1700 patients, the donor´s age more than 65 years correlated with development of ureteral stenosis (P = 0.001) (12). In the study with 1450 patients after kidney transplantation, there was no association between the gender and the ischemic time; source of the allograft and ischemic time; size of stricture and source of the allograft; and ischemic time and age (13).…”

Les complications chirurgicales de la transplantation rénale à partir du donneur vivant: expérience du CHU Ibn Sina de Rabat

“…La fréquence des sténoses urétérales (3,2%) dans notre série était conforme aux données de la littérature [5][6][7]. La cause principale est la sténose de l'uretère distal d'origine ischémique [7].…”

The modified Barry technique to prevent vesicoureteric reflux in paediatric renal transplant recipients: Initial recipient outcomes

“…Ureteric obstruction is a major cause of chronic allograft nephropathy, rejection and recurrence of the initial nephropathy [9]. Ureteric obstruction occurring beyond the first postoperative month remains common (2e7.5%) [10,11] and mostly related to ureteral stenosis.…”