Englesbe M J, Dubay D A, Gillespie B W, Moyer A S, Pelletier S J, Sung R S, Magee J C, Punch J D, Campbell D A, Merion R M
Department of Surgery, Division of Transplantation and School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Am J Transplant. 2007 Jun;7(6):1536-41. doi: 10.1111/j.1600-6143.2007.01790.x. Epub 2007 Apr 8.
Urinary complications are common following renal transplantation. The aim of this study is to evaluate the risk factors associated with renal transplant urinary complications. We collected data on 1698 consecutive renal transplants patients. The association of donor, transplant and recipient characteristics with urinary complications was assessed by univariable and multivariable Cox proportional hazards models, fitted to analyze time-to-event outcomes of urinary complications and graft failure. Urinary complications were observed in 105 (6.2%) recipients, with a 2.8% ureteral stricture rate, a 1.7% rate of leak and stricture, and a 1.6% rate of urine leaks. Seventy percent of these complications were definitively managed with a percutaneous intervention. Independent risk factors for a urinary complication included: male recipient, African American recipient, and the "U"-stitch technique. Ureteral stricture was an independent risk factor for graft loss, while urinary leak was not. Laparoscopic donor technique (compared to open living donor nephrectomy) was not associated with more urinary complications. Our data suggest that several patient characteristics are associated with an increased risk of a urinary complication. The U-stitch technique should not be used for the ureteral anastomosis.
肾移植后泌尿系统并发症很常见。本研究的目的是评估与肾移植泌尿系统并发症相关的危险因素。我们收集了1698例连续肾移植患者的数据。通过单变量和多变量Cox比例风险模型评估供体、移植和受体特征与泌尿系统并发症的相关性，该模型用于分析泌尿系统并发症和移植失败的事件发生时间结局。105例（6.2%）受体出现泌尿系统并发症，输尿管狭窄率为2.8%，漏尿和狭窄率为1.7%，尿漏率为1.6%。这些并发症中有70%通过经皮介入得到了明确处理。泌尿系统并发症的独立危险因素包括：男性受体、非裔美国受体和“U”形缝合技术。输尿管狭窄是移植失败的独立危险因素，而尿漏不是。腹腔镜供体技术（与开放性活体供肾切除术相比）与更多泌尿系统并发症无关。我们的数据表明，一些患者特征与泌尿系统并发症风险增加有关。“U”形缝合技术不应被用于输尿管吻合。
