Ureteric complications following renal transplantation: an eight years experience.
OBJECTIVE
Ureteric complications (UCs) following renal transplantation (RT) cause significant morbidity and ureteric stents are employed to bridge the vesico-ureteric anastomosis with a view to preventing these complications. The purpose of this study was to examine the incidence of UCs and outcomes following RT in both stented (STG) and non-stented groups (NSTG) of RT patients.


METHODS
This is a retrospective study of a cohort of 650 consecutive RTs [STG (N=267; 41%) and NSTG (N=383; 59%)] performed over a period of 8 years, where the data were retrieved from a prospectively maintained computerised database and case-notes.


RESULTS
The overall incidence of UCs was 6.5% (42/650), which consisted of ureteric obstruction (UO) in 4.3% (28) and ureteric leak (UL) in 2.2%(14) of patients. The incidence of UO was significantly high in the NSTG compared to the STG (6.3% vs.1.5%; P=0.002). However, the incidence of UL (3.4% vs.1.3%; P=0.1) and post-transplant urinary tract infection (UTI) (44% vs.41%; P=0.57) were not significantly different between the STG and NSTG groups. UO and UL were associated with significantly high incidence of UTI (P=0.001 and 0.01, respectively). All UCs were managed successfully without allograft loss.


CONCLUSIONS
Routine stenting of ureteric anastomosis resulted in reduced incidence of UO without concomitant increased risk of UTI.
Shrestha
B M
BM
Renal Transplant Unit, University Hospital of Wales, Heath Park, Cardiff, UK. shresthabm@doctors.net.uk
Darby
C R
CR
Moore
R H
RH
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D014515:Ureteral Diseases / Q000453:epidemiology / Q000209:etiology*