Skip to main content
SpringerLink
Log in

Late ureteral obstruction after kidney transplantation

Fibrotic answer to previous rejection?

  • Brief Report
  • Published:
Transplant International

Abstract

Today, the incidence of urological complications following renal transplantation is 2%–10%. Most of these complications occur within the 1st year and affect the distal ureter. We report on two patients who developed very late ureteral obstruction, 14 and 18 years after transplantation. Both patients had rejection episodes 1 and 10 months prior to the ureteral stenosis. Histological examination of one resected ureter revealed findings strongly suggestive of a rejection process. Open surgery with antirefluxive reimplantation into the bladder was successful in both patients, with a postoperative observation time of 20 and 8 months, respectively. We conclude that a percutaneous nephrostomy may be required in patients with rising creatinine and incipient hydronephrosis even long after transplantation has been performed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Barry JM, Lawson RK, Strong D, Kodges C (1974) Urologic complications in 173 kidney transplants. J Urol 112:567–571

    PubMed  Google Scholar 

  2. Dreikorn K (1992) Problems of the distal ureter in renal transplantation. Urol Int 49: 76–89

    PubMed  Google Scholar 

  3. Dreikorn K, Röhl L (1975) Urological complications in renal transplantation. Eur Urol 1: 170–177

    PubMed  Google Scholar 

  4. Dreikorn K, Rössler W, Horsch R, Kohl P, Rauterberg ES, Palmtag H (1982) Incidence, causes and significance of reflux in patients in endstage renal disease and after renal transplantation. Dial Transplant 11: 126–130

    Google Scholar 

  5. Fjeldborg O, Kim CH (1972) Ureteral complications in human renal transplantation. Urol Int 27: 417–431

    PubMed  Google Scholar 

  6. Haber MH, Putong PB (1965) Ureteral vascular rejection in human renal transplants. JAMA 192:157–159

    Google Scholar 

  7. Katz JP, Greenstein M, Hakki A, Miller A, Katz SM, Simonian S (1988) Transitional epithelial lesions of the ureter in renal transplant rejection. Transplantation 45: 710–714

    PubMed  Google Scholar 

  8. Kirkman RL, Strom TB, Weir MR, Tilney NL (1982) Late mortality and morbidity in recipents of long-term allografts. Transplantation 34: 347–351

    PubMed  Google Scholar 

  9. Krane RJ, Cho Si, Olsson LA (1973) Renal transplant ureteral obstruction simulating retroperitoneal fibrosis. JAMA 225: 607

    PubMed  Google Scholar 

  10. Loughlin KR, Tilney NL, Richie JP (1984) Urological complications in 718 renal transplant patients. Surgery 95: 297–302

    PubMed  Google Scholar 

  11. MacKinnon KJ, Oliver JA, Morehouse DD, Taguchi Y (1968) Cadaver renal transplantation: emphasis on urological aspects. J Urol 99: 486–488

    PubMed  Google Scholar 

  12. MacLean LD, MacKinnon KG, Inglis FG, Dossetor JB (1969) When should renal allografts be removed? Arch Surg 99: 269

    PubMed  Google Scholar 

  13. Mundy AR, Podesta ML, Bewick M, Rudge CJ, Ellis FG (1981) The urological complications of 1000 renal transplantations. Br J Urol 53: 397–402

    PubMed  Google Scholar 

  14. Rainer K, Largiader F, Uhlschmid G, Binswanger U, Leisinger HJ (1976) Urologische Komplikationen nach Nierentransplantation. Urol Int 31: 272–289

    PubMed  Google Scholar 

  15. Robertshow GE, Madge GE, Kauffmann HM Jr (1966) Ureteral pathology in treated and untreated renal homografts. Surg Forum 17: 236–238

    PubMed  Google Scholar 

  16. Rosenthal JT (1990) Complications of renal transplantation and autotransplantation. In: Smith RB, Ehrlich RM (eds) Complications of urologic surgery. Prevention and management, 2nd edn. W B. Saunders, Philadelphia, p 231

    Google Scholar 

  17. Schweizer RT, Bartus SA, Kahn CS (1977) Fibrosis of a renal transplant ureter. J Urol 117: 125–126

    PubMed  Google Scholar 

  18. Shoskes DA, Hanböry D, Granston D, Morris RJ (1995) Urological complications in 1000 consecutive renal transplant patients. J Urol 153: 18–21

    PubMed  Google Scholar 

  19. Straffon RA, Kiser WS, Stewart BH, Hewitt CB, Gifford RW Jr, Nakamoto S (1968) Four years clinical experience with 138 kidney transplants. J Urol 99: 479–485

    PubMed  Google Scholar 

  20. Thomalla JV, Lingeman JE, Leapman SB, Filo RS (1985) The manifestation and management of late urological complications in renal transplant recipients: use of the urological armamentarium. J Urol 134: 944–948

    PubMed  Google Scholar 

  21. Williams G, Birtch AG, Wilson RE, Harrison JH, Murray JE (1970) Urological complications of renal transplantation. Br J Urol 42: 21–28

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Ulrich Maier & Stefan Madersbacher

  2. Department of Nephrology, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Silvia Banyai-Falger

  3. Institute of Clinical Pathology, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Martin Susani

  4. Department of Surgery, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Thomas Grünberger

Authors
  1. Ulrich Maier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefan Madersbacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Silvia Banyai-Falger
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin Susani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thomas Grünberger
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Maier, U., Madersbacher, S., Banyai-Falger, S. et al. Late ureteral obstruction after kidney transplantation. Transplant Int 10, 65–68 (1996). https://doi.org/10.1007/BF02044345

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02044345

Key words

Search

Navigation