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. 2013 Sep;5(4):878-83.
doi: 10.5812/numonthly.10881. Epub 2013 Aug 3.

Impact of ureteral length on urological complications and patient survival after kidney transplantation

Majid Ali-Asgari  1 , Farid Dadkhah  1 , Alireza Ghadian  2 , Mohammad Hossein Nourbala  2
Affiliations

Impact of ureteral length on urological complications and patient survival after kidney transplantation

Majid Ali-Asgari et al. Nephrourol Mon. 2013 Sep.

Abstract

Background: Urologic complications are of the most important complications after kidney transplantation which increases mortality and morbidity significantly.

Objectives: We designed this study to evaluate the association between ureteral length and postoperative complications.

Patients and methods: We recorded the length of the transplanted ureter during the operation. Ureter-to-bladder anastomosis was performed using modified Lich-Gregoir method on the ureteral stent. Complications like urine leakage and increased creatinine were evaluated. We used both univariate and multivariate analyses and survival analysis according lengths of ureter. It means that the main variable is ureteral length and other variables are studied based on it.

Result: A total of 395 patients with the mean age of 37 years (range, 18 to 68 years) were enrolled in the study, twenty six graft lost during the follow-up period. The Mean age of recipients was 37 ± 13 years. Urinary stenosis was seen in 6 patients (1.5%) and urinary leakage in 4 (1%) patients. The complication rate was not significantly different between these groups (P = 0.67). We found that there were no significant difference among complication (P = 0.25), hospitalization (P = 0.31) and survival (P = 0.84) at 5.5 cm length cut off.

Conclusions: The length of transplanted ureter does not affect the postoperative urologic complications (including urinary fistula and ureter-to-bladder anastomosis stricture), and it seems that decreased rate of complication frequency during the recent years is due to technical improvement, surgeon's skillfulness and development in use of immunosuppressant's postoperatively.

Keywords: Complications; Kidney Transplantation; Ureter.

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Figures

Figure 1.
Figure 1.. Roc Curve of Ureteral Length and Graft Loss
Figure 2.
Figure 2.. Kaplan-Meier Survival of Patient With Ureteral Length Less and More than 9.5 cm
Figure 3.
Figure 3.. Box Plot of Hospitalization Difference Regarding Ureteral Length Less and More Than 9.5 cm
Figure 4.
Figure 4.. Bar Chart Shows Complication After Kidney Transplantation in Ureteral Length Less and more Than 9.5 cm
See this image and copyright information in PMC

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