Abstract
Ureteral complications after renal transplantation in children are a major source of morbidity. Management is complex and variable. With IRB approval, health records were retrospectively reviewed of patients who: were <18years, underwent kidney transplant between 1997 and 2017, had at least 2years of follow-up, and underwent interventions due to post-transplant ureteral complications. Of 136 patients, seventeen (13%) required ureteral intervention due to stricture (n=3), reflux (n=12), or both (n=2). Transplant occurred at median 10.5years (3.1-14.7). Reconstruction occurred at median 10months (7-15) after transplant. Pre-existing bladder pathology was present in 6 (35%) patients. Four of five patients with strictures had at least one endoscopic balloon dilation. Ultimate management included reimplantation, ureteroureterostomy of native to transplant ureter, pyeloureterostomy to native ureter, multiple endoscopic interventions followed by a Boari flap, or multiple failed endoscopic interventions. Fourteen patients with VUR underwent reimplantation (n=5), ureteroureterostomyof native to transplant ureter (n=4), pyeloureterostomyto native ureter (n=4), and one underwent endoscopic injection with Deflux of the transplant ureter. Only one patient had a non-functioning graft due to ureteral complication. All patients were alive at follow-up (median 17years [12-19]). Transplant ureteral reflux and stricture are significant complications following pediatric renal transplantation and may require surgical management. In our population, reflux or stricture requiring ureteral reconstruction occurred in 10% and 4%, respectively. Endoscopic interventions were rarely successful. Native ureters were used for ureteral reconstruction in more than two thirds of patients should be considered in management of ureteral complications.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.