+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Urological complications and vesicoureteral reflux following pediatric kidney transplantation



Urological complications and vesicoureteral reflux following pediatric kidney transplantation



Journal of Urology 189(3): 1071-1076



Ureteral complications of renal transplantation can dramatically impact renal outcomes. We studied whether complications are associated with preexisting genitourinary pathology or transplant using a deceased donor allograft. We retrospectively reviewed all patients undergoing renal transplantation at our institution between 2000 and 2010. We abstracted patient demographic details, donor type (living vs deceased), end-stage renal disease etiology, reimplant technique, stent use, preoperative and postoperative imaging, history of lower genitourinary pathology and postoperative complication management. A total of 211 kidneys were transplanted into 206 patients (mean age 13.7 years, mean followup 4.6 years). Most patients (89%) underwent extravesical ureteroneocystostomy without stenting (97%), with roughly half (47%) of transplants being from living donors. Preexisting urological pathology was present in 34% of cases. Postoperative obstruction or extravasation occurred in 16 cases (7.6%), of which 15 were acute. Complications were not associated with donor type, preexisting urological pathology other than posterior urethral valves, surgical technique, etiology of end-stage renal disease or patient age. However, posterior urethral valves or other preexisting genitourinary pathology was not associated with an increased likelihood of genitourinary complications. Posterior urethral valves were associated with development of postoperative vesicoureteral reflux (OR 6.7, p = 0.004) but were not associated with stent placement, surgical technique, donor type or etiology of end-stage renal disease. Patients with posterior urethral valves undergoing renal transplantation are at increased risk for postoperative vesicoureteral reflux but not for other acute surgical complications. There is no association between donor type, etiology of end-stage renal disease, surgical technique or patient age and increased complications.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056788342

Download citation: RISBibTeXText

PMID: 23022008

DOI: 10.1016/j.juro.2012.09.091


Related references

Urological complications, vesicoureteral reflux, and long-term graft survival rate after pediatric kidney transplantation. Pediatric Transplantation 19(8): 844-848, 2015

Urologic Surgical Complications And Postoperative Vesicoureteral Reflux Following Pediatric Kidney Transplantation. The Journal of Urology 187(4): e484-e485, 2012

Vesicoureteral reflux after pediatric kidney transplantation FT Reflujo vesicoureteral tras trasplante renal en la edad pediatrica. 2008

Vesicoureteral reflux after pediatric kidney transplantation. Archivos Espanoles de Urologia 61(2): 335-340, 2008

Incidence of urological complications in pediatric kidney transplantation. Pediatric Nephrology 12(7): C199, 1998

Urological complications following kidney transplantation in pediatric age: A single-center experience. Pediatric Transplantation 20(4): 485-491, 2016

Pediatric Vesicoureteral Reflux Guidelines Panel summary report on the management of primary vesicoureteral reflux in children. Journal Of Urology. 157(5): 1846-1851, 1997

Vesicoureteral Reflux in Kidney Transplantation. Progress in Transplantation 27(2): 196-199, 2017

Screening of vesicoureteral reflux in pediatric patients with kidney transplantation showing non-specific interstitial fibrosis and tubular atrophy with interstitial Tamm-Horsfall protein deposits in protocol allograft biopsy. Clinical Transplantation 23(Suppl. 20): 2-5, 2009

Vesicoureteral reflux after kidney transplantation in children. Pediatric Transplantation 11(5): 498-503, 2007

Vesicoureteral reflux after kidney transplantation in children. Nephrology Dialysis Transplantation 15(11): 1852-1858, 2000

When does vesicoureteral reflux in pediatric kidney transplant patients need treatment?. Pediatric Transplantation 22(8): E13299, 2018

Clinical significance of vesicoureteral reflux after kidney transplantation. Clinical Nephrology 40(1): 38-45, 1993

Vesicoureteral reflux. I. Studies on mechanism which prevents vesicoureteral reflux. II. Influences of vesicoureteral reflux on the upper urinary tract. Mie Medical Journal 19(1): 1-16, 1969

Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report: Clinical Practice Guidelines for Screening Siblings of Children With Vesicoureteral Reflux and Neonates/Infants With Prenatal Hydronephrosis. Journal of Urology 184(3): 1145-1151, 2010