title: Urological complications following kidney transplantation in pediatric age: A single-center experience.
abstract: Surgical complications during kidney transplantation can seriously affect renal outcomes. We assess occurrence, risk factors, and results of all urological complications in a series of renal transplants in a single center. Children who underwent renal transplant between January 2008 and December 2014 were retrospectively evaluated. Postoperative urological complications were reviewed. Demographic details, cause of ESRD, donor type, and surgical procedures at transplant were analyzed. For statistical analysis, the chi-square test or Fisher's exact test were used as appropriate. One hundred and twenty-one kidney transplants were performed in 117 children (median age 12 yr). Sixty-two of 121 (53%) had an underlying urological malformation. At a median follow-up of three yr, 28 urological complications were recorded (23%): 12 lymphocele (10%), 10 ureteral obstruction (8%), three urinary leakage (2.5%), two symptomatic VUR (1.7%), and one hydropyonephrosis. When lymphocele was excluded, the complication incidence rate dropped to 13%. Ureteral obstruction mostly occurred late after transplant (more than six months). Presence of urological malformation was the only factor related to increased occurrence of urological complication (p = 0.007) and, in particular, ureteral obstruction (p = 0.018). Children with urological malformations presented a statistically significant risk of developing urological complications after kidney transplantation, ureteral obstruction being the most common complication.
authors.affiliation: Department of Nephrology and Urology, "Bambino Gesù" Children's Hospital, Institute for Scientific Research, Rome, Italy.|DINOGMI University of Genoa, "Giannina Gaslini" Children's Hospital, Institute for Scientific Research, Genoa, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Rossi
authors.affiliation: Department of Nephrology and Urology, "Bambino Gesù" Children's Hospital, Institute for Scientific Research, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Torino
authors.affiliation: Department of Nephrology and Urology, "Bambino Gesù" Children's Hospital, Institute for Scientific Research, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Gerocarni Nappo
authors.affiliation: Department of Nephrology and Urology, "Bambino Gesù" Children's Hospital, Institute for Scientific Research, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Mele
authors.affiliation: Department of Nephrology and Urology, "Bambino Gesù" Children's Hospital, Institute for Scientific Research, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Innocenzi
authors.affiliation: DINOGMI University of Genoa, "Giannina Gaslini" Children's Hospital, Institute for Scientific Research, Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mattioli
authors.affiliation: Department of Nephrology and Urology, "Bambino Gesù" Children's Hospital, Institute for Scientific Research, Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Capozza
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014570:Urologic Diseases / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: children; complications; kidney transplantation