Ojeda-Alcalá Á Aburto-Morales S, Soel-Encalada J, Rodríguez-Castellanos F, Mendoza-Valdez A, Franco-Guevara M, Mancilla-Urrea E

Language: Spanish
References: 8
Page: 9-14
PDF size: 292.35 Kb.

ABSTRACT

Objective: To know the incidence, types and management of urological complications. Methods: A retrospective and descriptive study; the files of 676 patients who had a renal transplantation from June 1968 to February 2005 were studied. The analyzed variables were: age, sex, diagnosis of renal failure, HLA, CMV, donor type, ischemia times, type of ureteroneocystostomy, immunosuppression, type and time of presentation of the complication, management, diagnostic methods, renal function at 6 and 12 months with serum creatinine, histopathology, complications and infections. Results: Of the 676 transplantations carried out, 11.06% presented urological complications, the most frequent being urinary fistula. The treatment was with a ureteral reimplantation plus the use of a double-J stent, uretero-uretero anastomosis, pyelo-uretero anastomosis, fistula closure plus double-J stent, nephrostomas, cystorrhaphy, Ureteral splinting with Nelaton catheter, conservative treatment using Foley’s catheter, Epiplon patch and the of freeing the ureter. There were post-surgical infections in 33 of the transplants. The histopathology showed damage due to ischemia. The average creatinine level at 6 and 12 months post-treatment was 1.6 mg/dl and 1.63 mg/dl, respectively. Conclusion: The urological complications continue to accompany renal transplantation for all types of donor. Urinary fistulas continue to be the most common complication, and within these, the most common is that located in the zone of the neocystoureteroanastomosis. Early surgical treatment is the best surgical alternative.

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