Results of surgical revisions for ureteral complications after renal transplantation

• Published in: Progrès en urologie (Paris) Vol. 29; no. 10; p. 474
• Main Authors: Abdo, N, Murez, T, Cabaniols, L, Robert, M, Marchal, S, Amadane, N, Thezenas, S, Iborra, F, Thuret, R
• Format: Journal Article
• Language: French
• Published: France 01-09-2019
• Subjects: Aged; Constriction, Pathologic - surgery; Female; Humans; Kidney Transplantation; Male; Middle Aged; Postoperative Complications - surgery; Reoperation; Retrospective Studies; Treatment Outcome; Ureteral Obstruction - surgery; Urinary Incontinence - surgery; Sténose urétérale; Ureteral complication; Complication urétérale; Reprise chirurgicale; Ureteric stenosis; Surgical revision; Transplantation rénale; Urinary leakage; Fistule urinaire; Kidney transplantation
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2019.05.010

To analyze the results of surgical revision for ureteral complication (ureteric stenosis or urinary leakage) after renal transplantation over a period of 10 years.
We performed a retrospective study on 1313 consecutive kidney transplantations carried out in a University Hospital Center between 2005 and 2014. The data of the patients who developed a ureteral stenosis or a urinary leakage secondary to a renal transplantation were analyzed. Combined organ transplantations (kidney-liver and kidney-pancreas), as well as pediatric transplantations were excluded.
Seventy-six patients (5.8%) had ureteric stenosis or urinary leakage after renal transplantation. Forty-six patients (3.5%) underwent surgical revision: 27 for ureteral stenosis, 19 for urinary leakage. Early success was achieved in 26 patients (56.5%), including 14 ureteric stenosis (51.9%) and 12 urinary leakage (63.2%) (P=0.45). After a complementary endoscopic or surgical treatment, the final success rate was increased to 73.1% (34 patients): 20 ureteric stenosis (74.1%) and 14 urinary leakage (73.7%) (P=0.98). There were 2 graft losses (4.3%) and one death (2.2%). The mean glomerular filtration rate estimated by the MDRD was 44.58mL/min/1.73m
(±14.7) before surgery and 45.37mL/min/1.73m
(±16.5) 6 months after surgery (P=0.92).
Although frequently challenging, surgical revisions for ureteral complications after renal transplantation give good results, with a low rate of graft loss and mortality.
4.