Urologische Komplikationen nach Nierentransplantation

Abstract

Between August 1981 and May 2005, 1065 consecutive kidney transplants were performed at our center; 393 patients (36.9%) developed urological complications in the first 60 postoperative days. Urinary tract infections occurred in 28.5% of all patients. The major urological problems seen were urinary leakage and ureteral obstruction in 6.2% and 1.4% of the patients. Two grafts were lost due to severe urinary leakage. No patient death occurred due to urological complications. The incidence of urological complications is mainly influenced by the surgical procedure of organ retrieval and ureteroneocystostomy. With double-J stenting of the extravesical ureteroneocystostomy, we observed a significantly lower rate of urinary leakage but a higher rate of urinary tract infections in our series. Early diagnosis and treatment of urological complications may prevent further morbidity of our transplant patients.

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“…6 Overall urologic complication rates after extravesical reimplant procedures have been reported to range from 2% to 12%. 10,[13][14][15][16] Ureteroureterostomy or pyeloureterostomy have displayed similar rates, ranging from 1.9% to 12.6%. 6,17,18 The results reviewed here fall within this range.…”

Results of secondary ureteral implantation after kidney transplantation

“…The main reasons for ureteral complications are inappropriate preparation of the transplant ureter and technical faults during transplantation, both leading to ischemia followed by necrosis and/or fibrosis [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Rejections, recurrent infections, and compression of the transplant ureter due to hematoma, lymphocele, or urinoma may also play a significant role as described in a few publications [3].…”

“…Delay in accurate diagnosis or inadequate management may result in increased morbidity including loss of transplant function or even death [2][3][4]. However, in most publications dealing with ureteral complications after kidney transplantation, no data on long-term transplant function and/or mortality are reported [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

“…Urological complications occur in 5-10% and remain the most common type of surgical problems following kidney transplantation [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The most frequent urological complications include ureteral stenosis, ureteral leakage, urinary tract infection, and ureteropelvic reflux [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

“…The most frequent urological complications include ureteral stenosis, ureteral leakage, urinary tract infection, and ureteropelvic reflux [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The majority of these complications develop within 3 months after transplantation.…”