Urologic Complications in Renal Transplantation

Abstract

Complications from the urinary tract occurred in 28 out of 67 renal transplantation patients with functioning transplants. That most commonly recorded was urinary leakage (17 cases). The complications were not more frequent in recipients of cadaveric kidneys than in those receiving living donor kidneys, but the consequences were more severe in the former group. Three of these patients lost the kidney as a result of hemorrhage or infection due to leakage, and two of them later died. No such sequels to leakage were encountered in the living donor group.

Urinary leakage was more common when a pelvoureteric or uretero-ureteric type of anastomosis had been constructed than when the ureter had been implanted into the bladder.

Urinary outflow obstruction occurred early in five and late in three cases, and was successfully corrected. Necrosis of the recipients's ureter occurred in two cases, leading to a fatal outcome in one, and the ureter of the transplanted kidney became necrotic in one case. The importance is stressed of preserving the recipient's ureter for use in such cases.