title: Ureteral complications in renal transplant recipients successfully treated with interventional radiology.
abstract: BACKGROUND
  Ureteral complications in renal transplantation occur in approximately 8% of renal transplant recipients, occasionally leading to graft loss. This retrospective study presents a single-center experience in managing ureteral complications with interventional radiology as well as the long-term graft function and recipient survival.
  
  
  METHODS
  We analyzed 21 renal transplant recipients with ureteral problems.
  
  
  RESULTS
  Nine patients experienced urinary leak, six patients had ureteric obstruction, and six patients had obstruction preceded by leak. Median recipient age was 48 (range, 20-63) years; 71% (15/21) of the patients were male and 66.6% (14/21) of transplants were derived from cadaveric donors. Ureteral complications were diagnosed at a mean of 18 days (range, 12-47) after renal transplantation. Initially a percutaneous nephrostomy was performed, followed by antegrade placement of a nephroureteral stent. In cases with ureteral obstruction, ureteral balloon dilation was performed prior to placement of the stent. Median time to the procedure was 53 days, and median follow-up for the purposes of this study was 57 months. Renal graft function improved following treatment of the ureteral complication. Mean serum creatinine values prior to and after the intervention were 4.8 +/- 2.12 and 1.79 +/- 0.58 mg/dL, respectively (P < .0001). Functional renal grafts were observed at the first, third, and fifth posttransplantation year among 100%, 95.2% and 80.9% of patients, respectively. It should be further noted that no graft was lost due to a ureteral complication.
  
  
  CONCLUSIONS
  Interventional radiology was successful in treating immediate and long-term ureteral problems among renal transplant recipients with preservation of good renal function and patient survival.
authors.affiliation: Department of Radiology, Asklipeion Hospital, Athens, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Kaskarelis
authors.forename: M
authors.initials: M
authors.lastname: Koukoulaki
authors.forename: T
authors.initials: T
authors.lastname: Georgantas
authors.forename: E
authors.initials: E
authors.lastname: Bairamidis
authors.forename: C
authors.initials: C
authors.lastname: Kokkinos
authors.forename: M
authors.initials: M
authors.lastname: Ieronymou
authors.forename: V
authors.initials: V
authors.lastname: Vougas
authors.forename: S
authors.initials: S
authors.lastname: Drakopoulos
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D017741:Survivors; D014463:Ultrasonography; D014515:Ureteral Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000532:radiotherapy*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery; D055815:Young Adult