Résultats des reprises chirurgicales pour complications urétérales après transplantation rénale

Abdo, Nicolas; Murez, T.; Cabaniols, L.; Robert, M; Marchal, Stéphane; Amadane, N.; Thézenas, Simon; Iborra, François; Thuret, Rodolphe

doi:10.1016/j.purol.2019.05.010

Cited by 2 publications

(4 citation statements)

References 22 publications

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“…In this context, surgical complications may occur in up to 15% of cases, most of which related to the urinary tract (5.9%) 6 . Among the urinary complications, the most common are ureteral stenosis and fistula, with incidences ranging from 2.7% to 6.5% and 1.6% to 5.4%, respectively 7 .…”

Section: Discussionmentioning

confidence: 99%

Ultrashort anisoperistaltic end-to-side ureteroureterostomy in renal transplantation

Leão

Foinquinos

Mello

et al. 2022

Rev. Col. Bras. Cir.

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The improvement of surgical techniques in kidney transplantation aims to reduce the incidence of post-transplant complications, contributing to the reduction of hospital stay, related costs, morbidity and mortality, in addition to improving the quality of life of patients. The choice of the best technique is influenced by several factors and the most common technique for urinary tract reconstruction in transplants is performed with implantation of the ureter of the graft in the caudal position, with the anastomosis performed in the bladder. However, the kidney pole can be inverted and the graft ureter anastomosis can be performed directly on the recipient’s ureter, facilitating venous and ureteral anastomoses and reducing urological complications.

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Section: Discussionmentioning

confidence: 99%

Ultrashort anisoperistaltic end-to-side ureteroureterostomy in renal transplantation

Leão

Foinquinos

Mello

et al. 2022

Rev. Col. Bras. Cir.

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“…[7][8] Aside from urinary tract infections, ureteral strictures are the most common urological complication following KT. 9 Reported incidences range from 0.5 to 6.8% [2][3][4][5][9][10][11][12][13][14][15][16][17][18][19] and the majority of cases occur within three months post KT. 14,17,20 Early cases are thought to be related to surgical technique of KT or ischemic fibrosis, whereas later cases are attributed to ureteral fibrosis or compression by the surrounding fibrotic tissue.…”

Section: Introductionmentioning

confidence: 99%

“…6 Some reported risk factors for ureteral strictures include older donor age (> 65 years), recipient male sex, kidneys with more than 2 arteries, delayed graft function, prolonged cold ischemia, fluid collections around the ureter, and BK virus infections. 11,[16][17][21][22] There is disagreement regarding the role of surgical technique as a risk factor, with some studies reporting a link, 6,[16][17]21 while others do not, 23 and this may be related to whether a refluxing or non-refluxing anastomosis technique is utilized.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies report immediate open surgical repair (surgical reimplantation of the ureter) as the gold standard and optimal first line of treatment, 5,10,17,[19][20] whereas other cohorts benefited more from minimally invasive treatments, such as percutaneous nephrostomy (PN) with balloon dilation. 11,14,24 Yet others report no significant differences in the success or negative outcomes between the two types of interventions, calling for a case-by-case approach. 16,25 Success rates of radiologic interventions and surgical interventions seem to be comparable at 71 to 86% and 80%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Ureteral strictures post-kidney transplantation: Trends, impact on patient outcomes, and clinical management

Minkovich¹,

Famure²,

Li³

et al. 2021

CUAJ

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Introduction: Ureteral strictures post-kidney transplantation (KT) can be a significant morbidity to the patient, often requiring surgical intervention and impacting graft function. We sought to investigate the incidence, clinical management, and outcomes of ureteral strictures among kidney transplant recipients (KTRs) at a large, multi-organ transplant center. Methods: We conducted a single-center cohort study looking at KTRs who had transplant surgery from January 1, 2005 to March 31, 2017 with at least one-year followup (n=1742). Any KTRs done outside of our center or simultaneous multiorgan transplants were excluded. The Kaplan-Meier product-limit method was used to determine the incidence of ureteral strictures. Risk factors for ureteric strictures and clinical outcomes among patients with vs. without ureteric strictures were analyzed using Cox proportional hazards models. Results: The incidence of ureteral strictures was 1.31 (95% confidence interval [CI] 0.85, 2.01) per 100 person-years or a cumulative incidence of 1.2%. We did not find any donor or recipient demographic variables that were independently associated with an increased risk of ureteral stricture development. A large proportion was managed successfully with radiologic intervention alone (47.6%). Ureteral strictures were associated with death-censored graft failure (hazard ratio [HR] 7.17, 95% CI 2.81, 18.30), total graft failure (HR 3.04, 95% CI 1.41, 6.59), and hospital re-admission (HR 2.52, 95% CI 1.58, 4.00). Conclusions: Although uncommon, ureteral strictures can significantly impact patient outcomes after KT. A better understanding of risk factors and clinical management will be important to ensure optimal graft outcomes.

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Résultats des reprises chirurgicales pour complications urétérales après transplantation rénale

Cited by 2 publications

References 22 publications

Ultrashort anisoperistaltic end-to-side ureteroureterostomy in renal transplantation

Ultrashort anisoperistaltic end-to-side ureteroureterostomy in renal transplantation

Ureteral strictures post-kidney transplantation: Trends, impact on patient outcomes, and clinical management

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