Kutlutürk Koray, Şahin Tevfik Tolga, Çimen Serhan, Dalda Yasin, Gönültaş Fatih, Doğan Sait Murat, Altunışık Toplu Sibel, Ünal Bülent, Pişkin Turgut
Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey.
Clinic of Urology, Malatya Education and Research Hospital, Malatya, Turkey.
Turk J Surg. 2020 Mar 18;36(1):33-38. doi: 10.5578/turkjsurg.4605. eCollection 2020 Mar.
Major urinary complications such as urinary leaks, stenosis or urinary tract infections after kidney transplantation can lead to graft or patient loss. The effect of peritoneal dialysis on post-kidney transplantation complications have been discussed but its effect on ureteral stenosis is unknown. In this study, it was aimed to analyze factors effecting major ureteral complications after living donor kidney transplantation and impact of peritoneal dialysis and double J-stents (JJ stents).
This study included 116 adult to adult living donor kidney transplant patients. Factors effecting major urologic complications after living donor kidney transplantation were analyzed. The donors were primary relatives of the recipients.
Major urologic complications after living donor kidney transplantation was 8/116 (6.9%). Urinary leak was present in 2 (1.7%) patients. Ureteral stenosis was encountered in 6 (5.2%) patients. Double J stents were used in 84 (72.4%) of the cases. The effect of JJ ureteral stent was not statistically significant for urinary leak, ureteral stenosis (p= 0.074, p= 0.470, respectively). A total of 29 (25%) patients had peritoneal dialysis before kidney transplantation. Preoperative peritoneal dialyses and bacteriuria after kidney transplantation were independent risk factors for ureteral stenosis in multivariate analysis (p= 0.013, and p= 0.010 respectively).
In the guidance of the results of the present study, peritoneal dialysis prior to kidney transplantation and bacteriuria are independent risk factors for ureteral stenosis after living donor kidney transplantation. JJ stents have no effect on urologic complications after living donor kidney transplantation.
肾移植后主要的泌尿系统并发症，如尿漏、狭窄或尿路感染，可导致移植肾丢失或患者死亡。腹膜透析对肾移植后并发症的影响已有讨论，但对输尿管狭窄的影响尚不清楚。本研究旨在分析活体供肾移植后影响主要输尿管并发症的因素以及腹膜透析和双J支架（JJ支架）的影响。
本研究纳入了116例成人对成人活体供肾移植患者。分析了活体供肾移植后影响主要泌尿系统并发症的因素。供体为受体的一级亲属。
活体供肾移植后主要泌尿系统并发症发生率为8/116（6.9%）。2例（1.7%）患者出现尿漏。6例（5.2%）患者出现输尿管狭窄。84例（72.4%）病例使用了双J支架。JJ输尿管支架对尿漏、输尿管狭窄的影响无统计学意义（p分别为0.074和0.470）。共有29例（25%）患者在肾移植前进行了腹膜透析。多因素分析显示，术前腹膜透析和肾移植后菌尿是输尿管狭窄的独立危险因素（p分别为0.013和0.010）。
根据本研究结果，肾移植前的腹膜透析和菌尿是活体供肾移植后输尿管狭窄的独立危险因素。JJ支架对活体供肾移植后的泌尿系统并发症无影响。
