Impact of ureteral stricture and treatment choice on long‐term graft survival in kidney transplantation. Issue 8 (31st March 2018)

• Record Type: Journal Article
• Authors: Arpali, E.; Al‐Qaoud, T.; Martinez, E.; Redfield, R. R.; Leverson, G. E.; Kaufman, D. B.; Odorico, J. S.; Sollinger, H. W.
• Is Part Of: American journal of transplantation. Volume 18:Issue 8(2018)
• Page Start: 1977
• Page End: 1985
• Publication Date: 2018-03-31
• Subjects: clinical research/practice -- graft survival -- health services and outcomes research -- kidney (allograft) function/dysfunction -- kidney transplantation/nephrology -- urology; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14696
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : We aimed to evaluate the influence of urological complications occurring within the first year after kidney transplantation on long‐term patient and graft outcomes, and sought to examine the impact of the management approach of ureteral strictures on long‐term graft function. We collected data on urological complications occurring within the first year posttransplant. Graft survivals, patient survival, and rejection rates were compared between recipients with and without urological complications. Male gender of the recipient, delayed graft function, and donor age were found to be significant risk factors for urological complications after kidney transplantation ( P < .05). Death censored graft survival analysis showed that only ureteral strictures had a negative impact on long‐term graft survival ( P = .0009) compared to other complications. Death censored graft survival was significantly shorter in kidney recipients managed initially with minimally invasive approach when compared to the recipients with no stricture ( P = .001). However, graft survival was not statistically different in patients managed initially with open surgery ( P = .47). Ureteral strictures following kidney transplantation appear to be strongly negatively correlated with long‐term graft survival. Our analysis suggests that kidney recipients with ureteral stricture should be managed initially with open surgery, with better long‐term graft survival. Abstract : Retrospective analyses show that ureteral strictures following kidney transplantation are negatively correlated with long‐term graft survival and that open surgical management seems to be a better approach to treat these strictures.