[Stenosis in kidney transplantation].

OBJECT

Evaluate the incidence of ureterovesical stenosis in the renal transplant and its outcomes in the evolution of the allograft.

MATERIAL AND METHOD

Seventy three renal transplants were made between August 1988 and December 1995 in Italian Hospital in Buenos Aires. The mean follow up period was 35 months. The incidence of ureterovesical stenosis and its outcomes in the renal allograft were evaluated. Seven cases of ureterovesical stenosis were found. Clinic diagnosis was made in all cases (decreased filtration, diuresis rythm diminished, pain over the implant) confirmed with ecography that showed hydronefrosis and pielography percutaneous anterograde to check the cause of obstruction. Time elapsed between transplant and diagnosis of stenosis varied from 2 to 23 months. Inicial treatment was percutaneous derivation and then in all cases where renal function was recovered ureterovesical reimplant was made out, but ureterotomy in one of them.

RESULTS

Incidence of ureterovesical stenosis was 9.58% (seven patients). Two of the patients keep an adequate renal function, one has altered renal function, the forth lost the implant due to pyelonephritis, and the other three lost the implant due to cronic rejection between 6 and 18 months after diagnosis and treatment of stenosis.

CONCLUSIONS

Ureterovesical stenosis is an important cause for lost of renal allograft. Imaging is outstanding for diagnosis. Definitive treatment can be made by open reconstructive operation or endoscopy.