Abstract
Objective: Renal transplantation is the primary treatment method for end-stage kidney disease. Many reasons such as surgical reasons and infection may cause urological complications after transplantation. Management of renal transplantation urinary complications requires respectable surgical experience. In this study, we aimed to present the management of patients who require surgical reconstruction after renal transplantation at our center. Material and Methods: The data of 16 patients who underwent reconstructive surgery after transplantation were reviewed retrospectively. The patients' demographic data were evaluated. Which reconstructive method was applied to the patients, timing of surgical correction after transplantation, pre and post-surgical glomerular filtration rate (GFR) were evaluated. Result: Them mean age of the patients was 35.6 years. The mean time from transplantation to reconstructive surgery was 312 days. The average postoperative hospitalization time was 11.2 days. The earliest complication was total ureteral necrosis seen on the 21st postoperative day and the latest complication was vesicoureteral reflux (VUR) in our series. In patients who developed VUR, VUR was seen more than 6 months after the operation. Nephrostomy was placed in 75% of patients. Ureteroneocystostomy was applied to 3 patients (18.7%), one was applied with Boari flap, and two were applied with modified Lich-Gregoir technique. Pre-operative GFR inter-quantile range (IQR): 35.6-70.3, postoperative first-month GFR IQR: 47.4-69.5, third postoperative months GFR IQR: 50-74.5 were detected. A significant difference was observed between preoperative GFR and postoperative third month GFR (p=0.007). Conclusion: Reconstructive surgery following kidney transplantation is a challenging but effective method. Even if it is performed in different centers, complications after transplantation are likely to occur.
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