+ 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

Ureteral Complications in Kidney Transplantation: Analysis and Management of 853 Consecutive Laparoscopic Living-Donor Nephrectomies in a Single Center



Ureteral Complications in Kidney Transplantation: Analysis and Management of 853 Consecutive Laparoscopic Living-Donor Nephrectomies in a Single Center



Transplantation Proceedings 48(8): 2684-2688



We report the incidence and nature of ureteral and surgical complications in our series of 853 consecutive living-donor renal transplants after laparoscopic living-donor nephrectomy. The aim of this study was to analyze the therapeutic approaches to ureteral complications in kidney transplantations and their relationship with recipient outcome. The medical records of patients who underwent kidney transplantation from 2000 to 2014 were reviewed retrospectively. After the donor nephrectomies were performed with the use of laparoscopic, hand-assisted laparoscopic, and vesico-ureteral anastomosis, the recipient's ureteral complications were classified according to the mechanism and site of urinary tract involvement: anastomosis stricture, anastomosis leakage, vesico-ureteral reflux, and urolithiasis. Among the 853 cases of kidney transplantation, ureteral complications occurred in 66 patients (7.73%). The most common complication was urinary tract infection caused by vesico-ureteral reflux (n = 24, 2.81%), which was managed with by means of sub-ureteral polydimethylsiloxane injection. The second most common complication was the anastomosis site stricture (n = 23, 2.69%), which was treated by means of ureteral re-implantation or percutaneous nephrostomy. Anastomosis site leakage occurred in 11 patients (1.28%) and was managed by percutaneous nephrostomy with double-J stenting and drainage or ureteral re-implantation. Urolithiasis occurred in 8 patients (0.93%). There was an 8% rate of recipient ureteral complications at our institution. Of the 66 patients, 46 (5.4%) required surgical repair. The remaining 20 patients with ureteral complications were treated with conservative care or minimally invasive procedures. The keys to successful management of these problems are early diagnosis and prompt reconstruction whenever possible. Most ureteral complications are easily managed with a successful outcome with early intervention.

Please choose payment method:






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

Accession: 059208976

Download citation: RISBibTeXText

PMID: 27788801

DOI: 10.1016/j.transproceed.2016.06.054


Related references

Morbidity of 200 consecutive cases of hand-assisted laparoscopic living donor nephrectomies: a single-center experience. Journal of Transplantation 2012: 121523-121523, 2012

Simultaneous pancreas-kidney transplantation from living donor using hand-assisted laparoscopic donor surgery: single-center experience. Transplantation Proceedings 47(4): 1096-1098, 2015

Infectious complications in ABO-incompatible living donor kidney transplantation: a single center experience. Transplantation Proceedings 30(7): 3130-3132, 1998

Donor morbidity including biliary complications in living-donor liver transplantation: a single center analysis of 283 cases. Transplantation 94(7): E51-2; Author Reply E52-3, 2012

Donor morbidity including biliary complications in living-donor liver transplantation: single-center analysis of 827 cases. Transplantation 93(9): 942-948, 2012

Management of biliary complications following living donor liver transplantation--a single center experience. Langenbeck's Archives of Surgery 394(6): 1025-1031, 2009

Endoscopic Management of Biliary Complications After Living Donor Liver Transplantation: A Single Center Experience. Gastroenterology 148(4): S-977, 2015

Experience With 750 Consecutive Laparoscopic Donor Nephrectomies: A Call For Using A Standardized Classification Of Complications. The Journal of Urology 181(4): 809-810, 2009

Experience with 750 consecutive laparoscopic donor nephrectomies--is it time to use a standardized classification of complications?. Journal of Urology 183(5): 1941-1946, 2010

Ureteral stents are associated with reduced risk of ureteral complications after kidney transplantation: a large single center experience. Transplantation 93(3): 304-308, 2012

Cost analysis of living donor kidney transplantation in China: a single-center experience. Annals of Transplantation 17(2): 5, 2012

Surgical complications in 100 donor hepatectomies for living donor liver transplantation in a single Brazilian center. Transplantation Proceedings 42(2): 421-423, 2010

Results and complications of 50 laparoscopic nephrectomies for live donor renal transplantation. Transplantation Proceedings 37(9): 3673-3675, 2006

Biliary complications in 106 consecutive duct-to-duct biliary reconstruction in right-lobe living donor liver transplantation performed in 1 year in a single center: a new surgical technique. Transplantation Proceedings 43(3): 917-920, 2011

Can preemptive kidney transplantation guarantee longer graft survival in living-donor kidney transplantation? Single-center study. Transplantation Proceedings 42(3): 766-774, 2010