Ureteric Complications Following Kidney Transplantation



Ureteric Complications Following Kidney Transplantation


H. ALBIN GRITSCH

ERIC G. TREAT



Contemporary surgical techniques and improved medical management decreased ureteric complications following kidney transplantation from historical incidence rates of 12% to more conservative modern estimates around 5% (1,2,3,4). Albeit different centers and varying practices lead to fluctuating incidence rates seen in the literature, in today’s clinical realm, ureteric complications still persist. Many of these complications if promptly diagnosed and managed can be resolved with minimal impact to the patient’s long term outcome; however, sometimes they lead to significant morbidity, potential decrease in graft function and survival, and rarely mortality. In recent years, development of less invasive techniques and management strategies fortunately diminished the need for open surgical intervention; however, some cases are best managed with open operative repair.




INDICATIONS FOR SURGERY

The primary indication for operative management is renal allograft dysfunction caused by underlying anatomic pathology (obstruction, leak, reflux) amendable to surgical correction. Rejection, infection, or other nonanatomic causes of allograft dysfunction need to be carefully excluded and treated prior to definitive operative management of an identified physical abnormality. Rapid placement of a percutaneous nephrostomy tube is indicated to relieve obstruction until more definitive treatment can be undertaken.

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Apr 24, 2020 | Posted by in UROLOGY | Comments Off on Ureteric Complications Following Kidney Transplantation
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