Management of Urologic Complications in Renal Transplantation: A Single-Center Experience

Hau, Hans Michael; Tautenhahn, Hans‐Michael; Schmelzle, Moritz; Krenzien, Felix; Schoenberg, Markus Bo; Morgül, Mehmet Haluk; Uhlmann, Dirk; Wiltberger, Georg; Rasche, Mareike; Bachmann, Anette; Jonas, Sven; Bartels, Michael

doi:10.1016/j.transproceed.2014.04.002

Cited by 29 publications

(18 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The majority of urological complications have been reported to occur in the early period after kidney transplantation, thus a low threshold of suspicion is essential to identify these early causes of graft dysfunction. The urological complication incidence of 9.3% cited in our study may be considered high when compared to recent similar studies, however, most of these studies only include ureteral stricture and urinary leaks as urological complications, while our study includes other urological complications such as VUR, lymphocele, dilatation of ureter or pelvis without stricture, and others. If our study only included ureteral strictures and urinary leaks, the total urological complication rate in this large series would be 4%.…”

Section: Discussionmentioning

confidence: 53%

“…The need for a native nephrectomy after UU/PU could be questioned, but the incidence of native kidney hydronephrosis requiring native nephrectomy would be expected to be very low in patients on chronic dialysis. Although no increase in morbidity was reported in some of the studies, the answer is not still clear . None of our patients treated initially with open surgical management required native nephrectomy.…”

Section: Discussionmentioning

confidence: 66%

“…Thus, comparison of UNC to UU/PU is not possible in our series due to the small numbers. In the literature, there are a few studies reporting higher obstruction rate for UU, but most of the current studies and a large‐scale meta‐analysis show similar urological complication rates between UNC and UU/PU groups . The need for a native nephrectomy after UU/PU could be questioned, but the incidence of native kidney hydronephrosis requiring native nephrectomy would be expected to be very low in patients on chronic dialysis.…”

Section: Discussionmentioning

confidence: 86%

See 2 more Smart Citations

Impact of ureteral stricture and treatment choice on long-term graft survival in kidney transplantation

Arpalı

Al‐Qaoud

Martinez

et al. 2018

American Journal of Transplantation

View full text Add to dashboard Cite

We aimed to evaluate the influence of urological complications occurring within the first year after kidney transplantation on long-term patient and graft outcomes, and sought to examine the impact of the management approach of ureteral strictures on long-term graft function. We collected data on urological complications occurring within the first year posttransplant. Graft survivals, patient survival, and rejection rates were compared between recipients with and without urological complications. Male gender of the recipient, delayed graft function, and donor age were found to be significant risk factors for urological complications after kidney transplantation (P < .05). Death censored graft survival analysis showed that only ureteral strictures had a negative impact on long-term graft survival (P = .0009) compared to other complications. Death censored graft survival was significantly shorter in kidney recipients managed initially with minimally invasive approach when compared to the recipients with no stricture (P = .001). However, graft survival was not statistically different in patients managed initially with open surgery (P = .47). Ureteral strictures following kidney transplantation appear to be strongly negatively correlated with long-term graft survival. Our analysis suggests that kidney recipients with ureteral stricture should be managed initially with open surgery, with better long-term graft survival.

show abstract

Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Impact of ureteral stricture and treatment choice on long-term graft survival in kidney transplantation

Arpalı

Al‐Qaoud

Martinez

et al. 2018

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…It has been shown that there are no significant differences in longterm follow-up results between reconstruction methods performed for posttransplant urological complications (16). A study revealed that pyeloureterostomy could be a favorable method compared to ureterocystostomy in ureteral complications (17).…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Ureteral Complications Following Renal Transplantations

Uysal¹,

Yüzbaşıoğlu²,

Dokur³

et al. 2015

jus

View full text Add to dashboard Cite

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...

show abstract

“…Currently, the treatment of choice for symptomatic VUR is open surgical re-implantation [9,10], which has a success rate of 83-100%. However, this is a difficult procedure and has a morbidity rate ranging from 16% to 53%, supporting the need for less invasive [11][12][13], simpler, and more cost-effective treatments. Antibiotic prophylaxis is one of the options available to prevent UTI in patients with kidney graft VUR.…”

Section: Introductionmentioning

confidence: 99%

Vesicoureteral Reflux Management With Subureteral Injection of Polydimethylsiloxane in Cases of Recurrent Pyelonephritis in Transplanted Kidneys

Aristizábal-Alzate

Salazar-Villa

Delgado

et al. 2016

World J Nephrol Urol

View full text Add to dashboard Cite

Background: Kidney graft pyelonephritis is a common complication after renal transplantation, often prompted by vesicoureteral reflux (VUR). An effective and minimally invasive strategy for managing reflux that allows a decrease in the risk of recurrent pyelonephritis is desirable. The aim of this study was to describe our experience with an endoscopic treatment with subureteral injection of polydimethylsiloxane for the treatment of recurrent pyelonephritis of renal grafts secondary to VUR. Methods: Between 2011 and 2016, 17 subureteral polydimethylsiloxane injection procedures were performed. Patient monitoring was done by outpatient consultation and medical record review. The number of pyelonephritis events before and after the procedure and its safety were compared. Results: Forty-six infection episodes occurred before the procedure (2.71 infections/patient/year) and 10 infection episodes occurred after the procedure (0.59 infections/patient/year), representing a 78.3% reduction of infections/patient/year. The procedure was well tolerated and safe, with no resultant obstructive complications or changes in renal function and no long-distance migration of the bulking agent detected by monitoring. Conclusion: Consistent endoscopic treatment with subureteral injection of the bulking agent polydimethylsiloxane to manage VUR in cases of recurrent pyelonephritis of kidney grafts is a non-invasive treatment option with a good success rate and safety profile.

show abstract

Management of Urologic Complications in Renal Transplantation: A Single-Center Experience

Cited by 29 publications

References 23 publications

Impact of ureteral stricture and treatment choice on long-term graft survival in kidney transplantation

Impact of ureteral stricture and treatment choice on long-term graft survival in kidney transplantation

Surgical Treatment for Ureteral Complications Following Renal Transplantations

Vesicoureteral Reflux Management With Subureteral Injection of Polydimethylsiloxane in Cases of Recurrent Pyelonephritis in Transplanted Kidneys

Contact Info

Product

Resources

About