Urologic complications in renal transplants

Choate, Hannah R.; Mihalko, Laura A.; Choate, Bevan T.

doi:10.21037/tau.2018.11.13

Cited by 22 publications

(27 citation statements)

References 42 publications

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“…A RVT occurs early and rarely after KT (0.1-0.5%) [29][30][31][32][33]. It is responsible for up to 75% of early allograft loss [34].…”

Section: Renal Artery Stenosis (Ras)mentioning

confidence: 99%

“…A RAT is rare (1%) [29,[31][32][33]. It results from poor technique, donor and recipient arterial intimal trauma and atherosclerosis, size disparity, kinking, hypotension, thrombophilia, acute rejection, external compression (haematoma or lymphocele), and immunosuppression toxicity.…”

Section: Renal Artery Stenosis (Ras)mentioning

confidence: 99%

“…In most cases, the graft is not salvageable, thus requiring nephrectomy. Selective angiographic thrombolytic therapy through the renal artery can be an alternative if a RAT is diagnosed <24 h and >10 days following KT [29,[31][32][33]. Routine postoperative anticoagulation does not reduce rate of RAT in low-risk patients [36].…”

Section: Renal Artery Stenosis (Ras)mentioning

confidence: 99%

“…It is responsible for up to 75% of early allograft loss [ 34 ]. Surgical errors, difficulties, and hyper-coagulative states are the main risk factors [ 33 ]. CDUS shows a swollen graft, reduced or no venous flow, and a plateau reversed diastolic arterial signal [ 35 ].…”

Section: Guidelinesmentioning

confidence: 99%

“…Preserving periureteric fat during harvesting maintains ureteric blood supply. Routine stenting is controversial with reports recommending it [ 33 ]. A recent systematic review and meta-analysis concluded that routine stenting does not lower the incidence of urine leakage or urological complications, and recommended stenting only in pathological bladders [ 42 ].…”

Section: Guidelinesmentioning

confidence: 99%

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Egyptian clinical practice guideline for kidney transplantation

Shokeir

Hassan

Shehab

et al. 2021

Arab Journal of Urology

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Objective : To present the first Egyptian clinical practice guideline for kidney transplantation (KT). Methods : A panel of multidisciplinary subspecialties related to KT prepared this document. The sources of information included updates of six international guidelines, and review of several relevant international and Egyptian publications. All statements were graded according to the strength of clinical practice recommendation and the level of evidence. All recommendations were discussed by the panel members who represented most of the licensed Egyptian centres practicing KT. Results : Recommendations were given on preparation, surgical techniques and surgical complications of both donors and recipients. A special emphasis was made on the recipient’s journey with immunosuppression. It starts with setting the scene by covering the donor and recipient evaluations, medicolegal requirements, recipient’s protective vaccines, and risk assessment. It spans desensitisation and induction strategies to surgical approach and potential complications, options of maintenance immunosuppression, updated treatment of acute rejection and chemoprophylactic protocols. It ends with monitoring for potential complications of the recipient’s suppressed immunity and the short- and long-term complications of immunosuppressive drugs. It highlights the importance of individualisation of immunosuppression strategies consistent with pre-KT risk assessment. It emphasises the all-important role of anti-human leucocyte antigen antibodies, particularly the donor-specific antibodies (DSAs), in acute and chronic rejection, and eventual graft and patient survival. It addresses the place of DSAs across the recipient’s journey with his/her gift of life. Conclusion : This guideline introduces the first proposed standard of good clinical practice in the field of KT in Egypt. Abbreviations : Ab: antibody; ABMR: Ab-mediated rejection; ABO: ABO blood groups; BKV: BK polyomavirus; BMI: body mass index; BTS: British Transplantation Society; CAN: chronic allograft nephropathy; CDC: complement-dependent cytotoxicity; CKD: chronic kidney disease; CMV: cytomegalovirus; CNI: calcineurin inhibitor; CPRA: Calculated Panel Reactive Antibodies; (dn)DSA: ( de novo ) donor-specific antibodies; ECG: electrocardiogram; ESWL: extracorporeal shockwave lithotripsy; FCM: flow cytometry; GBM: glomerular basement membrane; GN: glomerulonephritis; HIV: human immunodeficiency virus; HLA: human leucocyte antigen; HPV: human papilloma virus; IL2-RA: interleukin-2 receptor antagonist; IVIg: intravenous immunoglobulin; KT(C)(R): kidney transplantation/transplant (candidate) (recipient); (L)(O)LDN: (laparoscopic) (open) live-donor nephrectomy; MBD: metabolic bone disease; MCS: Mean channel shift (in FCM-XM); MFI: mean fluorescence intensity; MMF: mycophenolate mofetil; mTOR(i): mammalian target of rapamycin (inhibitor); NG: ‘n...

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“…A RVT occurs early and rarely after KT (0.1-0.5%) [29][30][31][32][33]. It is responsible for up to 75% of early allograft loss [34].…”

Section: Renal Artery Stenosis (Ras)mentioning

confidence: 99%

Section: Renal Artery Stenosis (Ras)mentioning

confidence: 99%

Section: Renal Artery Stenosis (Ras)mentioning

confidence: 99%

Section: Guidelinesmentioning

confidence: 99%

Section: Guidelinesmentioning

confidence: 99%

See 3 more Smart Citations

Egyptian clinical practice guideline for kidney transplantation

Shokeir

Hassan

Shehab

et al. 2021

Arab Journal of Urology

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Imaging findings of en bloc simultaneous liver-kidney transplantation

et al. 2020

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MRI for diagnosis of post-renal transplant complications: current state-of-the-art and future perspectives

Schutter

Lantinga

Borra

et al. 2019

Magn Reson Mater Phy

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Kidney transplantation has developed into a widespread procedure to treat end stage renal failure, with transplantation results improving over the years. Postoperative complications have decreased over the past decades, but are still an important cause of morbidity and mortality. Early accurate diagnosis and treatment is the key to prevent renal allograft impairment or even graft loss. Ideally, a diagnostic tool should be able to detect post-transplant renal dysfunction, differentiate between the different causes and monitor renal function during and after therapeutic interventions. Non-invasive imaging modalities for diagnostic purposes show promising results. Magnetic resonance imaging (MRI) techniques have a number of advantages, such as the lack of ionizing radiation and the possibility to obtain relevant tissue information without contrast, reducing the risk of contrast-induced nephrotoxicity. However, most techniques still lack the specificity to distinguish different types of parenchymal diseases. Despite some promising outcomes, MRI is still barely used in the post-transplantation diagnostic process. The aim of this review is to survey the current literature on the relevance and clinical applicability of diagnostic MRI modalities for the detection of various types of complications after kidney transplantation.

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Urologic complications in renal transplants

Cited by 22 publications

References 42 publications

Egyptian clinical practice guideline for kidney transplantation

Egyptian clinical practice guideline for kidney transplantation

Imaging findings of en bloc simultaneous liver-kidney transplantation

MRI for diagnosis of post-renal transplant complications: current state-of-the-art and future perspectives

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