Urological Complications in 1,223 Kidney Transplantations
Urological Complications in 1,223 Kidney Transplantations
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DOI：
10.1159/000241679
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发表时间：
2009-01-01
影响因子：
1.6
通讯作者：
Huo, W. Q.
中科院分区：
文献类型：
--
作者：
Nie, Z. L.;Zhang, K. Q.;Huo, W. Q.
简介：肾移植后的泌尿系统并发症可能导致移植物丢失。在这项研究中，我们回顾性审查了我们机构进行的 1,223 例肾移植中的泌尿系统并发症。材料与方法：研究不同尿路重建方式、输尿管膀胱造口术（U-C）和输尿管输尿管造口术（U-U）的不同方式，尿漏、输尿管梗阻、膀胱输尿管反流（VUR）等泌尿外科并发症的发生情况。结果：92例（7.5%）出现泌尿外科并发症，包括漏尿（n = 43，3.5%）、输尿管梗阻（n = 35，2.9%）和VUR（n = 14，1.1%）。 U-C组75例（7.9%），U-U组17例（6.2%）。 91名受者均获得成功救治，1名患者因肾盂、输尿管坏死而失去移植物。没有因这些并发症而导致受者丢失。对于患有泌尿系统并发症的受者，受者的 1 年和 3 年生存率分别为 90% 和 88%，移植物的 1 年和 3 年生存率分别为 87% 和 82%。结论：U-U 后，泌尿系统并发症的总体发生率与 U-C 后相同；然而，漏尿发生率明显下降。因此，U-U 是一个很好的首选，腔内泌尿外科解决输尿管狭窄的成功率更高，而且没有 VUR 风险。版权所有 (C) 2009 S. Karger AG，巴塞尔
Introduction: Urological complications after kidney transplantation may lead to graft loss. In this study, we retrospectively reviewed urological complications in 1,223 kidney transplantations that were performed at our institution. Materials and Methods: The occurrence of urological complications such as urine leakage, ureteral obstruction and vesicoureteral reflux (VUR) according to the different way of urinary tract reconstruction, ureteroneocystostomy (U-C) and ureteroureterostomy (U-U), was studied. Results: Urological complications were encountered in 92 (7.5%) cases, including urine leakage (n = 43, 3.5%), ureteral obstruction (n = 35, 2.9%) and VUR (n = 14, 1.1%). 75 cases (7.9%) were in the U-C group and 17 cases (6.2%) in the U-U group. 91 recipients were successfully treated, and 1 patient lost the graft due to kidney pelvis and ureteral necrosis. There was no recipient loss due to these complications. For recipients with urological complications, the 1- and 3-year survival rates were 90 and 88% for recipients and 87 and 82% for grafts, respectively. Conclusions: After U-U, the same number of overall incidences of urological complications is observed as after U-C; however, a decrease in the number of incidences of urine leakage is apparent. Therefore, U-U is a good first option with a greater success rate of resolving ureteral stenosis with endourology and no risk of VUR. Copyright (C) 2009 S. Karger AG, Basel