Minnee Robert C, Surachno Susanto, Kox Cees, ten Berge Ineke J M, Aronson Daniel C, Idu Mirza M
Department of Vascular and Transplant Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Transpl Int. 2006 Jul;19(7):558-62. doi: 10.1111/j.1432-2277.2006.00313.x.
Routine splinting of the ureterocystostomy during renal transplantation lowers the urological complication rate but increases patient's morbidity. The number needed to treat to prevent one urological complication is high. The aim of this study was to identify risk factors, which can be used in the implementation of a selective splinting ureterocystostomy protocol. Retrospective analysis of 475 consecutive renal transplantations performed between January 1999 and December 2004. Donor, surgical-technical and recipient factors were assessed. Urological complications occurred in 62 (13%) patients. In 29 of these 62 patients (6.1%), only a temporary percutaneous nephrostomy catheter was necessary and in 33 (6.9%) surgical revision was required. Episodes of acute rejection and delayed graft function were identified as the only independent risk factors for a urological complication: odds ratio 2.62 [95% confidence interval: (CI) 1.38-4.97] and 2.22 (95% CI: 1.14-4.33), respectively. None of the risk factors for urological complications after renal transplantation that are known at the time of performing the ureterocystostomy are useful for the implementation of a selective splinting protocol.
肾移植期间对输尿管膀胱吻合术进行常规支撑可降低泌尿系统并发症发生率，但会增加患者的发病率。预防一例泌尿系统并发症所需治疗的患者数量较多。本研究的目的是确定可用于实施选择性输尿管膀胱吻合术支撑方案的危险因素。对1999年1月至2004年12月期间连续进行的475例肾移植进行回顾性分析。评估供体、手术技术和受体因素。62例（13%）患者发生泌尿系统并发症。在这62例患者中的29例（6.1%），仅需临时放置经皮肾造瘘导管，33例（6.9%）需要手术修复。急性排斥反应和移植肾功能延迟被确定为泌尿系统并发症的唯一独立危险因素：优势比分别为2.62 [95%置信区间：(CI) 1.38 - 4.97] 和2.22 (95% CI: 1.14 - 4.33)。在进行输尿管膀胱吻合术时已知的肾移植后泌尿系统并发症的危险因素，均无助于实施选择性支撑方案。
