Buttigieg J, Agius-Anastasi A, Sharma A, Halawa A. Early urological complications after kidney transplantation: An overview. World J Transplantation 2018; 8(5): 142-149 [PMID: 30211022 DOI: 10.5500/wjt.v8.i5.142]
Corresponding Author of This Article
Ahmed Halawa, FRCS (Gen Surg), MD, MSc, Surgeon, Consultant Transplant Surgeon, Department of Transplantation, Sheffield Teaching Hospitals, Glossop Rd, Sheffield S10 2JF, United Kingdom. ahmed.halawa@liverpool.ac.uk
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplantation. Sep 10, 2018; 8(5): 142-149 Published online Sep 10, 2018. doi: 10.5500/wjt.v8.i5.142
Early urological complications after kidney transplantation: An overview
Jesmar Buttigieg, Andrei Agius-Anastasi, Ajay Sharma, Ahmed Halawa
Jesmar Buttigieg, Renal Division, Mater Dei Hospital, Msida MSD2090, Malta
Jesmar Buttigieg, Ajay Sharma, Ahmed Halawa, Faculty of Health and Science, Institute of Learning and Teaching, University of Liverpool, Liverpool L69 3BX, United Kingdom
Andrei Agius-Anastasi, Department of Medicine, Mater Dei Hospital, Msida MSD2090, Malta
Ajay Sharma, Department of Transplantation, Royal Liverpool University Hospital, Liverpool L7 8XP, United Kingdom
Ahmed Halawa, Department of Transplantation, Sheffield Teaching Hospitals, Sheffield S10 2JF, United Kingdom
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ahmed Halawa, FRCS (Gen Surg), MD, MSc, Surgeon, Consultant Transplant Surgeon, Department of Transplantation, Sheffield Teaching Hospitals, Glossop Rd, Sheffield S10 2JF, United Kingdom. ahmed.halawa@liverpool.ac.uk
Telephone: +44-114-2269696
Received: June 16, 2018 Peer-review started: June 16, 2018 First decision: July 8, 2018 Revised: July 21, 2018 Accepted: August 6, 2018 Article in press: August 6, 2018 Published online: September 10, 2018
Abstract
Urological complications, especially urine leaks, remain the most common type of surgical complication in the early post-transplant period. Despite major advances in the field of transplantation, a small minority of kidney transplants are still being lost due to urological problems. Many of these complications can be traced back to the time of retrieval and implantation. Serial ultrasound examination of the transplanted graft in the early post-operative period is of key importance for early detection. The prognosis is generally excellent if recognized and managed in a timely fashion. The purpose of this narrative review is to discuss the different presentations, compare various ureterovesical anastomosis techniques and provide a basic overview for the management of post-transplant urological complications.
Core tip: Urological complications, especially urine leaks, remain the most common type of surgical complication following kidney transplantation. Preservation of the peri-ureteric tissue during kidney retrieval, Lich-Gregoir ureteroneocystostomy technique and routine prophylactic ureteral stenting has been shown to decrease the incidence of these complications. Routine post-operative allograft ultrasound is important for their early detection. The majority of recipients can be effectively managed percutaneously, avoiding the morbidity associated with open surgery. The prognosis is generally excellent if recognized and treated successfully in a timely manner.
