Urology and Organ Transplantation Department, Memorial Hizmet Hospital, Istanbul, Turkey.
Urology and Organ Transplantation Department, Memorial Hizmet Hospital, Istanbul, Turkey.
Transplant Proc. 2023 Jun;55(5):1116-1120. doi: 10.1016/j.transproceed.2023.02.065. Epub 2023 May 1.
Laparoscopic donor nephrectomy (LDN) is the preferred method for kidney retrieval in live donor kidney transplantation. The surgical technique of LDN has improved over the years, but ureteral complications are still common after kidney transplantation. The relationship between the surgical technique in LDN and ureteral complications has been debated. This study aims to discuss ureteral complications and risk factors in kidney transplantation in a group of patients performed with a standard technique.
A total of 751 live donor kidney transplantations were included in the study. Age, sex, body mass index, concomitant metabolic diseases, nephrectomy side, multiple renal arteries, and several complete or incomplete duplicated ureters of donors were recorded. The recipient's age, sex, body mass index, duration of dialysis, the daily volume of urine before transplantation, accompanying metabolic diseases, and postoperative ureteral complications were also recorded.
Of the 751 patient donors included in the study, 433 (57.7%) were female, and 318 (42.3%) were male. Of the 751 recipients, 291 (38.7%) were female, and 460 (61.3%) were male. In the 751 recipients, there were 8 (1.0%) ureteral complications, all of which were ureteral strictures. No ureteral leaks or urinomas were noted in this series. There was no statistically significant relation between donor age, donor body mass index, donor side, presence of hypertension in the donor, presence of diabetes mellitus in the donor, or ureteral complications. The mean duration of dialysis and preoperative daily urine volume were associated with increased ureteral complications with statistical significance.
Recipient factors may affect ureteral complication rates in live donor kidney transplantation, donor nephrectomy technique, and gonadal vein preservation.
腹腔镜供体肾切除术（LDN）是活体供肾移植中获取肾脏的首选方法。LDN 的手术技术多年来有所改进，但肾移植后输尿管并发症仍很常见。LDN 中的手术技术与输尿管并发症之间的关系一直存在争议。本研究旨在讨论一组采用标准技术进行的患者的输尿管并发症和危险因素。
本研究共纳入 751 例活体供肾移植患者。记录供体的年龄、性别、体重指数、并存代谢性疾病、肾切除术侧、多发性肾动脉以及供体的多个完全或不完全重复输尿管。还记录了受者的年龄、性别、体重指数、透析时间、移植前每日尿量、并存代谢性疾病以及术后输尿管并发症。
在纳入研究的 751 例患者供体中，433 例（57.7%）为女性，318 例（42.3%）为男性。在 751 例受者中，291 例（38.7%）为女性，460 例（61.3%）为男性。在 751 例受者中，有 8 例（1.0%）发生输尿管并发症，均为输尿管狭窄。本系列未发现输尿管漏或尿囊肿。供体年龄、供体体重指数、供体侧、供体高血压、供体糖尿病与输尿管并发症之间无统计学显著关系。透析时间和术前每日尿量的平均值与输尿管并发症的增加有关，具有统计学意义。
受者因素可能影响活体供肾移植中输尿管并发症的发生率，包括供体肾切除术技术和生殖静脉的保留。
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