PATTERN, MANAGEMENT AND OUTCOME OF UROLOGICAL COMPLICATIONS IN FIRST POST-TRANSPLANT YEAR IN 50 CASES OF RENAL TRANSPLANT

Authors

  • Mohammad Ali Suhail
  • M. Saleh Khaskeli
  • Ameer Hamza

Abstract

Background: Chronic renal failure needs substitutive treatment such as haemodialysis and peritonealdialysis for the patients to survive. Kidney transplantation improves survival of patients with chronicrenal failure. This study was conducted to identify the pattern, management and outcome of urologicalcomplications in first post-transplant year in 50 cases of renal transplant recipients. Methods: Thiscase series study was conducted in the Department of Urology and Transplantation, Mayo Hospital,Lahore, during the period of three years, from Jan 2006 to Dec 2008. All 50 patients were admittedthrough outdoor department, Dialysis Unit, and directly referred from other hospitals. Donor andrecipient were evaluated thoroughly by history, examination, and laboratory investigations. All donorswere live related donors. After getting the proper tissue typing and HLA-matching transplant wasdone and recipients were thoroughly observed for the development of any urological complication infirst post-transplant year. Results: Total 8 (16%) subjects developed complications. Urinary leakagewas noticed in 3 patients. In one patient leakage stopped spontaneously while in remaining twopatients surgical procedure was carried out. Two patients developed uro-sepsis due to intractable UTI.Both were successfully treated with broad spectrum anti biotic. Ureteric stenosis was noticed in 2subjects. Indwelling JJ stent was placed in one case while remaining case was dealt withuretroneocystostomy. One cases developed Vesico-ureteric reflux. He was treated surgically.Conclusion: Early diagnosis and treatment of urological complication may prevent the furthermorbidity and decline in graft function.Keywords: pattern, complications, management, post-transplant, first year

References

Risaliti A, Sainz-Barriga M, Baccarani U, Adani GL, Montanaro

D, Gropuzzo M, et al. Surgical complications after kidney

transplantation. Ital Nefrol 2004;21(Suppl-26):S43–7.

Samhan M, Al-Mousawi, Hayati H, Abdullah M, Namoory MR.

Urological complications after renal transplantation. Transplant

Proc 2005;37:3075–6.

Bradely JA, Transpalantation. In Russell RCG, Williams NS,

Blustrode CJK. Bailly & Love’s Short Practice of Surgery, 23rd

ed. London: Nick Dunton; 2000. p.125–6.

Sehgal AR, LeBeau SO, Younger SJ. Dialysis patient attitude

towards financial incentives for kidney donation. Am J Kidney

Dis 2003;29:410–8.

Chugh KS, Jha V. Commerce in transplantation in third world

countries. Kidney Int 2005;49:1181–6.

Karam G, Maillet F, Braud G, Battisti S, Hétet JF, Glémain P, et

al. Surgical complications in kidney transplantation. Ann Urol

;41:261–75.

Akoh JA, Opaluwa AS, Weller D. Urological complications of

renal transplantation: Reducing the risk. Saudi J Kidney Dis

Transpl 2009;20:1005–9.

El Atat R, Derouiche A, Guellouz S, Gargah T, Lakhoua R,

Chebil M. Surgical complications in pediatric and adolescent renal

transplantation. Saudi J Kidney Dis Transpl 2010;21:251–7.

Dinckan A, Tekin A, Turkyilmaz S, Kocak H, Gurkan A,

Erdogan O, et al. Early and late urological complications

corrected surgically following renal transplantation. Transpl Int

;20:702–7.

Karam G, Hetet JF, Maillet F, Rigaud J, Hourmant M, Soulillou

JP, et al. Late ureteral Stenosis following renal transplantation:

risk factors and impact on patient and graft Survival Am J

Transplant 2006;6:352–6.

Król R, Ziaja J, Chudek J, Heitzman M, Pawlicki J, Wiecek A, et

al. Surgical treatment of urological complications after kidney

transplantation. Transplant Proc 2006;38:127–30.

Neri F, Tsivian M, Coccolini F, Bertelli R, Cavallari G, Nardo B,

et al. Urological Complications after kidney transplantation:

experience of more than 1,000 Transplantations. Transplant Proc

;41:1224–6.

Bemelman FJ, Ten Berge RJ. Late complications following renal

transplantation. Ned Tijdschr Genees Kd 2008;152:1317–21.

Buresely S, Samhan M, Moniri S, Codaj J, Al-Mousawi M. Post

renal transplantation urological complications. Transplant Proc

;40:2345–6.

Burmeiseter D, Noster M, Kram W, Kundt G, Seiter H.

Urological complications after kidney transplantation. Urologe A

;45(1):25–31.

Safa J, Nezami N, Tarzamni MK, Zarforooshan S, RahimiArdabili B, et al. Post-transplant urological and vascular

complications. Saudi J Kidney Dis Transp 2009;20:867–71.

Lapointe SP, Charbit M, Jan D, Lortat-Jacob S, Michel JL,

Beurton D, et al. Urological complications after renal

transplantation using uretro-ureteral anastomosis in children. J

Urol 2001;166:1046–8.

Saemann M, Horl WH. Urinary tract infection in renal transplant

recipients. Eur J Clin Invest 2008;38(Suppl 2):58–65.

Nie ZL, Li QS, Jin FS, Zhang KQ, Zhu FQ, Huo WQ, et al.

Urological Complications In 1223 kidney transplants. Urol Int

;89:1269–71.

Favi E, Spagnoletti G, Valentini AL, Tondolo V, Nanni G,

Citterio F, et al. Long-term clinical impact of vesico ureteral

reflux in kidney transplantation. Transplant Proc

;41:1218–20.

Downloads

Published

2011-03-01

Issue

Vol. 23 No. 1 (2011): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.