Approach to urological complications early post renal transplant

Урологические осложнения после трансплантации почки
Akbar Mahmood 1
More Detail
1 Nephrology Department, Sultan Qaboos University Hospital, Muscat, Oman
J CLIN MED KAZ, Volume 3, Issue 49, pp. 24-27. https://doi.org/10.23950/1812-2892-JCMK-00588
OPEN ACCESS 3137 Views 2384 Downloads
Download Full Text (PDF)

ABSTRACT

Kidney transplant has been proven treatment of choice for end stage renal disease population due to its benefit of being cost effective and conferring a natural way of way of life despite that fact, that transplantation journey is not devoid of some risks both surgical and medical. Amongst the surgical issues urological problems needs special attention, close surveillance for timely detection and intervention in order to safe guard renal allograft. These complications include lymphocele, seroma, ureteric obstruction and urinary leak. A very simple approach has been suggested to adopt which include concentrating on symptoms and signs, utilizing conventional diagnostic tools followed by appropriate intervention which include not only surgical but medical to curtail infection, adjusting immunosuppression, improving nutrition and mental and physical rehabilitation. This should be kept in mind that time is key to salvage the renal allograft by preserving nephrons. Time means nephrons and large number of nephron mass which has long term morbidity and mortality benefit. Multidisciplinary team based care strategy is mandatory to achieve success.
Keywords: lymphocele, seroma, ureteric obstruction and urinary leak

CITATION

Mahmood A. Approach to urological complications early post renal transplant. Journal of Clinical Medicine of Kazakhstan. 2018;3(49):24-7. https://doi.org/10.23950/1812-2892-JCMK-00588

REFERENCES

  • McDonald SP, Craig JC, Australian and New Zealand Paediatric Nephrology Association. Long-term survival of children with end-stage renal disease. N Engl J Med 2004; 350:2654.
  • National Kidney and Urologic Diseases Information Clearing house. Kidney disease statistics for the United States. National Institutes of Health; 2012. Publication No. 12e3895.
  • Routh JC, Yu RN, Kozinn SI, et al. Urological complications and vesicoureteral reflux following pediatric kidney transplantation. J Urol 2013; 189:1071.
  • Streeter EH, Little DM, Cranston DW, Morris PJ. The urological complications of renal transplantation: a series of 1535 patients. BJU Int 2002;90:627e34.
  • Lempinen J, Stenman J, Kyllonen L, Salmela K. Surgical complications following 1670 consecutive adult renal transplantations: a single center study. Scand J Surg 2015
  • O’Neill CW. Ultrasonography in renal transplantation. Am J Kidney Dis. 2002;39:663-678.
  • Bailey SH, Mone MC, Holman JM, Nelson W. Laparoscopic treatment of postrenal transplant lymphoceles. SurgEndosc 2003;17:1896e9
  • Kolonko RKA, Chudek J, Ziaja J, Pawlicki J, Maly A, Kunsdorf- Wnuk A, et al. Did volume of lymphocele after kidney transplantation determine the choice of treatment modality? Transplant Proc 2007;39:2740e3.
  • Kumar S, Ameli-Renani S, Hakim A, Jeon JH, Shrivastava S, Patel U. Ureteral obstruction following renal transplantation: causes, diagnosis and management. Br J Radiol 2014;87.20140169.
  • Bhayani SB, Landman J, Slotoroff C, Figenshau RS. Transplant ureter stricture: Acuciseendoureterotomy and balloon dilation are effective. J Endourol 2003;17:19e22.
  • El-Nahas AR. Retrograde endopyelotomy: a comparison between laser and Acucise balloon cutting catheter. CurrUrol Rep 2007;8:122e7.
  • Katz R, Pode D, Gofrit ON, Shenfeld OZ, Landau EH, Golijanin D, et al. Transurethral incision of Ureteroneocystostomy strictures in kidney transplant recipients. BJU Int 2003;92:769e71.
  • Kristo B, Phelan MW, Gritsch HA, Schulam PG. Treatment of renal transplant ureterovesical anastomotic strictures using ante grade balloon dilation with or without holmium:YAG laser endoureterotomy. Urology 2003;62:831e4
  • He Z, Li X, Chen L, Zeng G, Yuan J, Chen W, et al. Endoscopic incision for obstruction of vesico-ureteric anastomosis in transplanted kidneys. BJU Int 2008;102:102e6.
  • Gdor Y, Gabr AH, Faerber GJ, Wolf Jr JS. Holmium: yttriumaluminum-garnet laser endoureterotomy for the treatment of transplant kidney ureteral strictures. Transplantation 2008; 85:1318e21
  • Bachar GN, Mor E, Bartal G, Atar E, Goldberg N, Belenky A. Percutaneous balloon dilation for the treatment of early and late ureteral strictures after renal transplantation: long-term follow-up. CardiovascInterventRadiol 2004;27: 335e8.
  • Bromwich E, Coles S, Atchley J, Fairley I, Brown JL, Keoghane SR. A 4-year review of balloon dilation of ureteral strictures in renal allografts. J Endourol 2006;20: 1060e1.
  • Aytekin C, Boyvat F, Harman A, Ozyer U, Colak T, Haberal M. Percutaneous therapy of ureteral obstructions and leak after renal transplantation: long-term results. CardiovascIntervent Radiol 2007;30:1178e84.
  • Juaneda B, Alcaraz A, Bujons A, Guirado L, Diaz JM, Marti J, et al. Endourological management is better in early-onset ureteral stenosis in kidney transplantation. Transplant Proc 2005;37:3825e7
  • Nie ZL, Zhang KQ, Li QS, Jin FS, Zhu FQ, Huo WQ. Treatment of urinary fistula after kidney transplantation. Transplant Proc 2009;41:1624e6.
  • Benoit G, Blanchet P, Eschwege P, Alexandre L, Bensadoun H, Charpentier B. Insertion of a double pigtail ureteral stent for the prevention of urological complications in renal transplantation: a prospective randomized study. J Urol 1996;156: 881e4.
  • Dharnidharka VR, Stablein DM, Harmon WE. Post-transplant infections now exceed acute rejection as cause for hospitalization: a report of the NAPRTCS. Am J Transplant 2004; 4:384.
  • Hogan J, Pietrement C, Sellier-Leclerc AL, et al. Infection-related hospitalizations after kidney transplantation in children: incidence, risk factors, and cost. Pediatr Nephrol 2017; 32:2331.
  • Puliyanda DP, Stablein DM, Dharnidharka VR. Younger age and antibody induction increase the risk for infection in pediatric renal transplantation: a NAPRTCS report. Am J Transplant 2007; 7:662.
  • Silva A, Rodig N, Passerotti CP, et al. Risk factors for urinary tract infection after renal transplantation and its impact on graft function in children and young adults. J Urol 2010; 184:1462.
  • Dharnidharka VR, Agodoa LY, Abbott KC. Effects of urinary tract infection on outcomes after renal transplantation in children. Clin J Am Soc Nephrol 2007; 2:100.
  • Esezobor CI, Nourse P, Gajjar P. Urinary tract infection following kidney transplantation: frequency, risk factors and graft function. Pediatr Nephrol 2012; 27:651.
  • Matalon TA, Thompson MJ, Patel SK, Ramos MV, Jensik SC, Merkel FK. Percutaneous treatment of urine leaks in renal transplantation patients. Radiology 1990;174 (3 Pt 2) :1049e51.
  • Campbell SC, Streem SB, Zelch M, Hodge E, Novick AC. Percutaneous management of transplant ureteral fistulas: patient selection and long-term results. J Urol 1993;150: 1115e7.
  • Swierzewski SJ, Konnak JW, Ellis JH. Treatment of renal transplant ureteral complications by per cutaneous technique. J Urol 1993;149:986e7.
  • Bhagat VJ, Gordon RL, Osorio RW, LaBerge JM, KerlanJr RK, Melzer JS, et al. Ureteral obstructions and leaks after renal transplantation: outcome of percutaneous antegrade ureteral stent placement in 44 patients. Radiology 1998;209:159e67.
  • Alcaraz A, Bujons A, Pascual X, Juaneda B, Marti J, de la Torre P, et al. Percutaneous management of transplant ureteral fistulae is feasible in selected cases. Transplant Proc2005;37:2111e4.
  • Tavakoli A, Surange RS, Pearson RC, et al. Impact of stents on urological complications and health care expenditure in renal transplant recipients: results of a prospective, randomized clinical trial. J Urol 2007; 177:2260.
  • Dharnidharka VR, Araya CE, Wadsworth CS, et al. Assessing the value of ureteral stent placement in pediatric kidney transplant recipients. Transplantation 2008; 85:986.
  • Irtan S, Maisin A, Baudouin V, et al. Renal transplantation in children: critical analysis of age related surgical complications. Pediatric Transplant 2010; 14:512.