Acute kidney transplant failure following transurethral bladder polyp fulguration.
Ureteral obstruction and anastomotic leak represent the most common urologic complications of kidney transplantation. Delay in diagnosis or treatment can lead to allograft loss. Obstruction of the ureter occurs in 2% of kidney transplant recipients. Although the majority of cases are immediate technical complications of the operation, subsequent manipulation of the genitourinary system can result in iatrogenic ureteral injury. We report the case of a long-term kidney transplant recipient who developed obstructive uropathy and acute renal failure requiring dialysis after undergoing cystoscopy and bladder polyp fulguration. The etiology was inadvertent thermal injury of the ureteroneocystostomy incurred during the procedure. After attempted percutaneous management, definitive open repair resulted in a return of allograft function to baseline.
Collins
Bradley H
BH
Division of Transplantation, Departments of Surgery, Duke University Medical Center, Durham, NC 27710, USA. colli005@mc.duke.edu
Marroquin
Carlos E
CE
Tuttle-Newhall
Janet E
JE
Kuo
Paul C
PC
Preminger
Glenn M
GM
Butterly
David W
DW
D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D003251:Constriction, Pathologic / Q000209:etiology; D003558:Cystoscopy / Q000009:adverse effects; D004564:Electrocoagulation / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000601:surgery*; D006435:Renal Dialysis; D014515:Ureteral Diseases / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000601:surgery*