Whose Transplant Function Fails After Ureteral Revision Following Kidney Transplantation?

Doehn, Christian; Böse, Nina; Meyer, Alexander; Jocham, Dieter

doi:10.1016/j.transproceed.2010.01.075

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Major ureteric complications following renal transplantation are a significant source of morbidity, compromised graft function and can cause mortality . Ureteric stricture remains the most common major ureteric complication , with a varying incidence reported in the literature of between 0.6% and 12.5% of all renal transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

Ureteric reconstruction for the management of transplant ureteric stricture: a decade of experience from a single centre

et al. 2015

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SummaryThis study was conducted to review the outcomes of patients who had undergone surgical repair of a ureteric stricture following renal transplantation. All patients who developed a ureteric stricture and underwent ureteric reconstruction following renal transplantation, between December 2003 and November 2013, were reviewed. One thousand five hundred and sixty renal transplants were performed during the study period. Forty patients required surgical repair of a ureteric stricture (2.5%, 25 male, median age 48 ). The median time to stricture was 3 [1-149] months. 19 patients were reconstructed by reimplantation to the bladder, 18 utilized a Boari flap, two were a pre-existing ileal conduit and one was an anastomosis to a native ureter. In one patient, reconstruction was impossible and consequently an extra-anatomic stent was used. Two patients required re-operation for restricture and kinking. Median serum creatinine at 12 months following surgery was 148 [84-508] lmol/l. There was no 90-day mortality. Eleven grafts were lost at the time of this study, a median time of 11 [1-103] months after reconstruction. The incidence of ureteric stricture following renal transplant is low. Surgical reconstruction of the transplant ureter is the optimal treatment and is successful in the majority of patients.

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Section: Introductionmentioning

confidence: 99%

Ureteric reconstruction for the management of transplant ureteric stricture: a decade of experience from a single centre

et al. 2015

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“…Plusieurs études ont évalué les conséquences sur la fonction rénale et les pertes de greffon après reprise chirurgicale (3,12,13). Dans la série de Van Roijen portant sur 695 transplantations rénales (14), 42 patients (6%) ont eu une complication urétérale ayant nécessité une reprise chirurgicale.…”

Section: Discussionunclassified

Résultats des reprises chirurgicales pour complications urétérales après transplantation rénale

Abdo

Murez

Cabaniols

et al. 2019

Progrès en Urologie

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“…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. 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.…”

Section: Introductionmentioning

confidence: 99%

“…There is also a lack of consensus regarding the best clinical management for these complications. 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.…”

Section: Introductionmentioning

confidence: 99%

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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Whose Transplant Function Fails After Ureteral Revision Following Kidney Transplantation?

Cited by 7 publications

References 9 publications

Ureteric reconstruction for the management of transplant ureteric stricture: a decade of experience from a single centre

Ureteric reconstruction for the management of transplant ureteric stricture: a decade of experience from a single centre

Résultats des reprises chirurgicales pour complications urétérales après transplantation rénale

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

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