Ureteral obstructions and leaks after renal transplantation: outcome of percutaneous antegrade ureteral stent placement in 44 patients.
OBJECTIVE
To analyze the outcome of percutaneous antegrade ureteral stent placement for treatment of ureteral stenoses and leaks after renal transplantation.


METHODS
Antegrade pyelography and percutaneous ureteral stent placement were performed in 45 patients with ureteral obstruction (n = 40), leak (n = 3), or both (n = 2). Obstructions were graded as mild, moderate, or complete, and as early (< or = 3 months after transplantation) or late (> 3 months).


RESULTS
The outcome of stent placement was successful in 25 (57%) patients (average follow-up, 30 months). The ureteroneocystostomy (UNC) was the most common site of obstructions (22 of 41), leaks (four of five), and successful outcomes (16 of 22). Moderate obstructions were most common (29 of 41) and responded best to treatment (17 of 29). Eighteen (69%) of 26 early obstructions and five (33%) of 15 late obstructions were successfully managed percutaneously. All complications (12 of 45 patients) were minor, with infections the most common (n = 7). No mortality or allograft loss was attributable to stent placement.


CONCLUSIONS
Ureteral stents are safe and effective for the treatment of obstructions and leaks and are particularly effective for early and UNC obstructions. These stents may also be useful for temporary drainage.
Department of Radiology, University of California, San Francisco 94143-0628, USA.
V J
VJ
Bhagat
R L
RL
Gordon
R W
RW
Osorio
J M
JM
LaBerge
R K
RK
Kerlan
J S
JS
Melzer
P N
PN
Bretan
M W
MW
Wilson
E J
EJ
Ring
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014513:Ureter / Q000000981:diagnostic imaging; D014515:Ureteral Diseases / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy*; D014517:Ureteral Obstruction / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy*; D014567:Urography