Ureteral fistulae after kidney transplantation: Experience with 224 cases

Ureteral fistulae after kidney transplantation represent major early urological complications with reported incidence from 1.2% to 12% in large series. The aim of the study is to establish the incidence, types and ureteral fistula related morbidity and lethality rates, by donor type. From 1995. to 2001, a total of 224 kidney transplantations (171 from living and 53 from cadaveric donor) have been performed at the Institute of Urology and Nephrology in Belgrade. Mean patients age was 36,67 years (11- 64; SD=10,69). Ureteral fistulae appeared only after living donor transplantation in a total of five patients (2.2%) (p>0.05). In all patients open fistula repair was performed. Two patients had recidive ureteral fistula after primary and after secondary open repair. Following the third open repair one patient had lethal outcome. Ureteral fistulae after kidney transplantation still remain challenging urological problem with considerable morbidity and lethality rates.

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Analysis of donor selection for living related kidney transplantation and their postoperative outcome

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0206193l ◽

2002 ◽

Vol 130 (5-6) ◽

pp. 193-197

Author(s):

Visnja Lezaic ◽

Ljubica Djukanovic ◽

Dragana Radivojevic-Djokic ◽

Radmila Blagojevic-Lazic ◽

Stojanka Ristic ◽

...

Keyword(s):

Kidney Transplantation ◽

Selection Procedure ◽

Postoperative Outcome ◽

Careful Examination ◽

Family Relation ◽

Abo Incompatibility ◽

Living Donor Transplantation ◽

Kidney Transplantations ◽

Living Related ◽

Drop Outs

Lack of cadaveric organs for transplantation resulted in increased number of living related kidney donors examinations and consequent transplantations in our Department. Donor procedure, selection, drop-outs and final results for living related donors (LRD) were retrospectively analyzed in this paper. Between 1987 and 1994 202 potential LRD were examined. Most of them were females (59%) and about 30% were older than 60 years. The family relation between LRD and recipients were: parents (95%), siblings (3%), grandmother grandfather (1.5%) and uncle (0.5%). Potential LRD were informed on risks advantages and procedure of living donor transplantation. After primary information 26% of potential LRD gave up further examinations. Following immunological and clinical evaluations 48% of LRD actually donated a kidney. The other 26% were excluded during the selection procedure. High immunological risks including ABO incompatibility, HLA mismatches and positive cross match test were the reasons for drop outs of 35 potential LRD (17%). Five more donors were excluded for medical reasons: one because of low creatinine clearance and four because of neoplasms, discovered during examination (kidney, laryngeal, lung). Fourteen transplantation were not realized due to different recipient reasons: 5 of them had clinical contraindications, two died and in 7 cadaveric kidney transplantations were performed. Mild hypertension, coronary disease and diabetes mellitus type 2 were presented in 5 LRD accepted for transplantation. Five more had to be operated before donation (abdominal or urological operation). Early complications after donor nephrectomy were acute renal failure, stress ulcus, pleuropneumonia in three and thromboflebitis in two donors. In conclusion, although kidney transplantation from LRD is highly successful careful examination during selection procedure is indispensable.

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Risk Factors of Ureteral Stenosis in Kidney Transplant Recipients: A Retrospective Study in National Referral Hospital in Indonesia

Advances in Urology ◽

10.1155/2021/2410951 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Gampo A. Irdam ◽

Bobby Sutojo ◽

Putu A. R. Raharja

Keyword(s):

Risk Factors ◽

Kidney Transplantation ◽

Kidney Transplant ◽

Donor Number ◽

Kidney Transplant Recipients ◽

Ureteral Stenosis ◽

Ischemic Time ◽

Urological Complications ◽

Recipient Age ◽

Kidney Transplantations

Ureteral stenosis is one of the most common urological complications following kidney transplantations. It is occurred in 2–10% of patients and poses a significant problem to the patients as it may lead to permanent damage to renal damage. Identification of risk factors is important to prevent the incidence of ureteral stenosis. Thus, we aim to determine the risk factors of ureteral stenosis in the Indonesian population. This is a retrospective analysis of 487 kidney transplant patients performed in Cipto Mangunkusumo Hospital between 2014 and 2018. We collected and compared donor and recipient demography data in recipients who developed ureteral stenosis and recipients who did not develop ureteral stenosis. Ureteral stenosis was defined as the presence of hydronephrosis from ultrasound and increased number of serum creatinine. The overall incidence of ureteral stenosis post-kidney transplantation in our center is 6.6% (32 from 487 patients) from January 2014 until June 2018. We found that older donor and recipient age more frequent in developing ureteral stenosis post-kidney transplantation ( p < 0.001). We also found that donors with number of arteries more than 2 ( p < 0.001) and prolonged warm ischemic time ( p < 0.05) are more frequently to develop ureteral stenosis post-kidney transplantation. There is no association between type II diabetes mellitus and hypertension with ureteral stenosis in this study. Donor age, recipient age, donor number of arteries more than 2, and prolonged warm ischemia time are associated with ureteral stenosis after kidney transplantation.

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"Early" removal of the internal ureteral stent after kidney transplantation

Transplantologiya The Russian Journal of Transplantation ◽

10.23873/2074-0506-2020-12-4-278-285 ◽

2020 ◽

Vol 12 (4) ◽

pp. 278-285

Author(s):

A. V. Shabunin ◽

P. A. Drozdov ◽

D. A. Eremin ◽

I. V. Nesterenko ◽

D. A. Makeev ◽

...

Keyword(s):

Urinary Tract Infection ◽

Kidney Transplantation ◽

Urinary Tract ◽

Tract Infection ◽

Graft Loss ◽

Infectious Complications ◽

Ureteral Stent ◽

Early Removal ◽

Urological Complications ◽

Kidney Transplantations

Background. Urological complications are currently one of the main causes of the renal graft loss and the death of the recipient in the early and late periods after surgery. Objective. To reduce the risk of developing infectious complications after kidney transplantation by early removal of the internal ureteral stent. Material and methods. From June 2018 to March 2020, the Department of Organ and/or Tissue Transplantation of the City Clinical Hospital n.a. S.P. Botkin performed 89 deseased-donor kidney transplantations with the placement of an internal ureteral stent. Depending on the timing of stent removal, the patients were divided into 2 groups: the first group included 54 patients who had the stent removed on day 21, and the second group included 35 patients who had the stent removed on day 14. Results. No urological complications were recorded in both groups. Urinary tract infection was recorded in 8 patients (15%) in the first group, and in 1 patient (3%) in the second group (p = 0.01). Conclusion. Removal of the internal ureteral stent on the 14th day after kidney transplantation safely and reliably reduces the risk of a urinary tract infection development, improving the immediate results of the operation.

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Patient and kidney graft survival rates after first and second kidney transplantation

Transplantologiya The Russian Journal of Transplantation ◽

10.23873/2074-0506-2021-13-2-130-140 ◽

2021 ◽

Vol 13 (2) ◽

pp. 130-140

Author(s):

M. Sh. Khubutiya ◽

A. V. Pinchuk ◽

N. V. Shmarina ◽

I. V. Dmitriev ◽

V. E. Vinogradov ◽

...

Keyword(s):

Kidney Transplantation ◽

Graft Survival ◽

Survival Rates ◽

Kidney Graft ◽

Significant Difference ◽

Donor Type ◽

Expanded Criteria ◽

Expanded Criteria Donors ◽

Kidney Transplantations ◽

One Year

Introduction. Expanding donation criteria is one way of solving the problem of the increasing need of transplantation. The article is dedicated to comparison of the outcomes of first and second repeated kidney transplantation using grafts from standard criteria and expanded criteria donors.Aim. To evaluate 1-year and 5-year recipient and kidney graft survival rates after first and second kidney transplantation according to the donor type – standard criteria or expanded criteria donors.Material and methods. From 2007 till 2019 we performed 1459 kidney transplantations. The comparison study of outcomes of first (n=196) and second (n=143) kidney transplantations from standard criteria (n=245) and expanded criteria (n=94) donors was made.Results. There were no significant differences in a 1-year patient survival according to the donor type (98% and 95%, p=0.13). A 5-year recipient survival was significantly poorer after kidney transplantation from expanded criteria donors (97.6% and 88%, p=0.01). There were no significant differences in 1-year and 5-year graft survival rates according to the order of transplantation (p=0.21 and p=0.36). We found no significant difference in 1-year recipient survival after kidney transplantation from expanded criteria donors according to the order of transplantation (p=0.50). A 5-year recipient survival was significantly difference poorer after second kidney transplantation from expanded criteria donors (p=0.04). One-year and 5-year graft survival rates were significantly lower after kidney transplantation from expanded criteria donors (94%, 88% vs 86%, 65%, p=0.0025 and p=0.0011, respectively). One-year and 5-year survival rates were higher after first kidney transplantation from standard criteria donors in comparison with second kidney transplantation (p=0.052 and p=0.02, statistically significant in both cases). Analyzing outcomes of kidney transplantation from expanded criteria donors we found 1-year and 5-year graft survivals to be higher after first kidney transplantation comparing with second kidney transplantation (p=0.030 and p=0.018, statistically significant in both cases).Conclusion. In case of second organ transplantation, it is reasonable to use organs from standard criteria donors.

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Urological Complications in Kidney Transplantation: Ureterocystostomy versus Uretero-Ureterostomy

Transplantation Proceedings ◽

10.1016/j.transproceed.2005.06.079 ◽

2005 ◽

Vol 37 (6) ◽

pp. 2518-2520 ◽

Cited By ~ 24

Author(s):

A. Faenza ◽

B. Nardo ◽

G. Fuga ◽

G. Liviano-D’Arcangelo ◽

F. Grammatico ◽

...

Keyword(s):

Kidney Transplantation ◽

Urological Complications

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LONG-TERM GRAFT SURVIVAL AFTER UROLOGICAL COMPLICATIONS OF 695 KIDNEY TRANSPLANTATIONS

The Journal of Urology ◽

10.1016/s0022-5347(05)66234-9 ◽

2001 ◽

Vol 165 (6 Part 1) ◽

pp. 1884-1887 ◽

Cited By ~ 34

Author(s):

J. HERMAN van ROIJEN ◽

WIM J. KIRKELS ◽

ROBERT ZIETSE ◽

JOKE I. ROODNAT ◽

WILLEM WEIMAR ◽

...

Keyword(s):

Graft Survival ◽

Urological Complications ◽

Kidney Transplantations

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An Update on Early Urological Complications in Kidney Transplantation: A National Cohort Study

Annals of Transplantation ◽

10.12659/aot.920086 ◽

2019 ◽

Vol 24 ◽

pp. 617-624 ◽

Cited By ~ 1

Author(s):

Moira H.D. Bruintjes ◽

Frank C.H. d’Ancona ◽

Xiaoye Zhu ◽

Andries J. Hoitsma ◽

Michiel C. Warlé

Keyword(s):

Cohort Study ◽

Kidney Transplantation ◽

Urological Complications ◽

National Cohort

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FC 117TIME TRENDS IN PROBABILITY OF STARTING HOME DIALYSIS OVER A 20 YEAR PERIOD: A DUTCH REGISTRY STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab127.003 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Anna Bonenkamp ◽

Tiny Hoekstra ◽

Marc Hemmelder ◽

Anita Van Eck van der Sluijs ◽

Alferso C Abrahams ◽

...

Keyword(s):

Kidney Transplantation ◽

The Netherlands ◽

Risk Model ◽

The Elderly ◽

Dialysis Patients ◽

Dialysis Treatment ◽

Home Dialysis ◽

System Utilization ◽

Number Of Patients ◽

Kidney Transplantations

Abstract Background and Aims A growing number of patients suffers from End Stage Kidney Disease(ESKD), causing a logistical and economic burden to the healthcare system. Utilization of home dialysis is low in many countries worldwide, although home dialysis has several advantages including higher quality of life and possibly lower costs. The aim of this study is to explore time trends in the use of home dialysis in the Netherlands. Method Anonymized registry data from the Dutch Renal Registry (RENINE) were used for this study. All dialysis episodes of adult patients who started dialysis treatment between 1997 through 2016 in the Netherlands were included, including those who previously underwent kidney transplantation. Dialysis episodes shorter than 90 days were excluded. The probability of starting home dialysis between 1997 through 2016 was evaluated in time periods of 5 years, using logistic regression analysis. Home dialysis was defined as start with peritoneal dialysis or home haemodialysis, or transfer to either within 2 years after dialysis start. A logistic multilevel model was used to adjust for clustering at patient level. The cumulative incidence function of start of home dialysis in incident patients was estimated with a competing risk model with recovery of kidney function, kidney transplantations, and all-cause mortality as competing events. All analyses were stratified for age categories at dialysis start: 20-44 years, 45-64 years, 65-74 years and ≥75 years. Results A total of 33,340 dialysis episodes in 31,569 patients were evaluated. Between 1997 and 2016, mean age at start of dialysis treatment increased from 62.5±14.0 to 65.5±14.5 years in in-centre haemodialysis patients, whereas it increased from 51.9±15.1 to 62.5±14.6 years in home dialysis patients. In patients < 65 years, the probability of starting home dialysis was significantly lower during each 5-year period compared to the previous period, and kidney transplantation occurred more often. In patients ≥ 65 years, incidence of home dialysis remained constant, whereas mortality decreased. Conclusion In patients < 65 years, the overall probability of starting home dialysis declined consistently over the past 20 years. The age of home dialysis patients increased more rapidly than that of in-centre dialysis patients, implying that pre-dialysis education and organization of home dialysis must be adapted to the needs of the elderly patient. These developments have a significant impact on the organisation of home dialysis for patients with ESKD.

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COVID-19 and Living Donor Kidney Transplantation in Naples during the Pandemic

BioMed Research International ◽

10.1155/2020/5703963 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Gaia Peluso ◽

Silvia Campanile ◽

Alessandro Scotti ◽

Vincenzo Tammaro ◽

Akbar Jamshidi ◽

...

Keyword(s):

Kidney Transplantation ◽

Living Donor ◽

Viral Infections ◽

Elective Surgery ◽

Deceased Donor ◽

Kidney Transplants ◽

Donor Kidney ◽

Transplant Center ◽

Living Donor Transplantation ◽

Donor Kidney Transplantation

Introduction. SARS-CoV-2 is a virus that causes a potentially deadly syndrome that affects especially the respiratory tract. Kidney-transplanted patients are immunosuppressed and more susceptible to viral infections. We have examined our transplantation activity to explore the future role of kidney transplantation from deceased and living donors in COVID-19 era. Patients and Methods. The activity of our transplant center of Naples (one of the two transplant centers in Campania, South Italy) continued during the COVID-19 pandemic. We have analysed the kidney transplants carried out between March 9 and June 9, 2020, comparing these data with the numbers of procedures performed in the two previous years. Moreover, we have considered the possibility of performing living donor transplants during a worldwide pandemic. Results. From March 9, 2020, when the Italian lockdown begun, till June 9, 2020, five kidney transplants have been performed at our transplant center in Naples, all from deceased donors. The donors and the recipients have been screened for COVID-19 infection, and the patients, all asymptomatic, followed strict preventive measures and were fully informed about the risks of surgery and immunosuppression during a pandemic. All the transplanted patients remained COVID negative during the follow-up. The number of transplants performed has been constant compared to the same months of 2018 and 2019. In agreement with the patients, we decided to postpone living donor transplants to a period of greater control of the SARS-CoV-2 spread in Italy. Conclusion. Deceased donor kidney transplantation should continue, especially in a region with moderate risk, like Campania, with a more careful selection of donors and recipients, preferring standard donors and recipients without severe comorbidities. Living donor transplantation program, instead, should be postponed to a period of greater control of the SARS-CoV-2 spread, as it is an elective surgery and its delay does not determine additional risks for patients.

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