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Treatment of ureteral complications after kidney transplantation with native ureteropyelostomy reduces the risk of pyelonephritis


Lehmann, K; Müller, M K; Schiesser, M; Wildi, S; Fehr, T; Wüthrich, R P; Clavien, P A; Weber, M (2011). Treatment of ureteral complications after kidney transplantation with native ureteropyelostomy reduces the risk of pyelonephritis. Clinical Transplantation, 25(2):201-206.

Abstract

Lehmann K, Müller MK, Schiesser M, Wildi S, Fehr T, Wüthrich RP, Clavien P-A, Weber M. Treatment of ureteral complications after kidney transplantation with native ureteropyelostomy reduces the risk of pyelonephritis. Clin Transplant 2010: DOI: 10.1111/j.1399-0012.2010.01234.x. (c) 2010 John Wiley & Sons A/S. Abstract: Urological complications contribute to morbidity and graft loss after kidney transplantation. Aim of this study was to assess the role of revisional surgery on patient outcome. From 1997 to 2007, 887 patients underwent kidney transplantation in our institution. Clinical data of patients with urological complications were analyzed. Ureteral complications were observed in 50 of 887 (5.6%) recipients, including ureteral necrosis (0.9%), stenosis (3.6%) and ureteral reflux with recurrent graft pyelonephritis (1.1%). Thirty-five patients underwent native ureteropyelostomy, and 14 patients had redo-ureterocystostomy. All patients treated for recurrent graft pyelonephritis had no further episodes. Overall, the rate of ureteral stenosis was significantly higher after secondary surgery, compared to the primary anastomosis (10% vs. 3.6%, p = 0.039). A significantly lower incidence of graft pyelonephritis was observed in patients after native ureteropyelostomy compared to patients treated with redo-ureterocystostomy (p = 0.019). In conclusion, reflux and recurrent graft pyelonephritis can be treated effectively by secondary surgery. The use of native ureteropyelostomy may offer protection from graft pyelonephritis after secondary surgery.

Lehmann K, Müller MK, Schiesser M, Wildi S, Fehr T, Wüthrich RP, Clavien P-A, Weber M. Treatment of ureteral complications after kidney transplantation with native ureteropyelostomy reduces the risk of pyelonephritis. Clin Transplant 2010: DOI: 10.1111/j.1399-0012.2010.01234.x. (c) 2010 John Wiley & Sons A/S. Abstract: Urological complications contribute to morbidity and graft loss after kidney transplantation. Aim of this study was to assess the role of revisional surgery on patient outcome. From 1997 to 2007, 887 patients underwent kidney transplantation in our institution. Clinical data of patients with urological complications were analyzed. Ureteral complications were observed in 50 of 887 (5.6%) recipients, including ureteral necrosis (0.9%), stenosis (3.6%) and ureteral reflux with recurrent graft pyelonephritis (1.1%). Thirty-five patients underwent native ureteropyelostomy, and 14 patients had redo-ureterocystostomy. All patients treated for recurrent graft pyelonephritis had no further episodes. Overall, the rate of ureteral stenosis was significantly higher after secondary surgery, compared to the primary anastomosis (10% vs. 3.6%, p = 0.039). A significantly lower incidence of graft pyelonephritis was observed in patients after native ureteropyelostomy compared to patients treated with redo-ureterocystostomy (p = 0.019). In conclusion, reflux and recurrent graft pyelonephritis can be treated effectively by secondary surgery. The use of native ureteropyelostomy may offer protection from graft pyelonephritis after secondary surgery.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nephrology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:11 Jan 2011 14:55
Last Modified:05 Apr 2016 14:31
Publisher:Wiley-Blackwell
ISSN:0902-0063
Publisher DOI:10.1111/j.1399-0012.2010.01234.x
PubMed ID:20384713

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