Faculty Collaboration Database

Impact of ureteral stricture and treatment choice on long-term graft survival in kidney transplantation. Am J Transplant 2018 Aug;18(8):1977-1985

Date

02/16/2018

Pubmed ID

29446225

DOI

10.1111/ajt.14696

Scopus ID

2-s2.0-85044587259 (requires institutional sign-in at Scopus site)   28 Citations

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.

Author List

Arpali E, Al-Qaoud T, Martinez E, Redfield RR III, Leverson GE, Kaufman DB, Odorico JS, Sollinger HW

Author

Emre Arpali MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Constriction, Pathologic
Delayed Graft Function
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Kidney Failure, Chronic
Kidney Transplantation
Male
Middle Aged
Patient Selection
Postoperative Complications
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Ureteral Obstruction