Maier U, Madersbacher S, Banyai-Falger S, Susani M, Grünberger T
Department of Urology, University of Vienna, Austria.
Transpl Int. 1997;10(1):65-8. doi: 10.1007/BF02044345.
Today, the incidence of urological complications following renal transplantation is 2%-10%. Most of these complications occur within the 1st year and affect the distal ureter. We report on two patients who developed very late ureteral obstruction, 14 and 18 years after transplantation. Both patients had rejection episodes 1 and 10 months prior to the ureteral stenosis. Histological examination of one resected ureter revealed findings strongly suggestive of a rejection process. Open surgery with antirefluxive reimplantation into the bladder was successful in both patients, with a postoperative observation time of 20 and 8 months, respectively. We conclude that a percutaneous nephrostomy may be required in patients with rising creatinine and incipient hydronephrosis even long after transplantation has been performed.
如今，肾移植后泌尿系统并发症的发生率为2% - 10%。这些并发症大多发生在第1年内，且累及输尿管远端。我们报告了2例患者，他们在移植后14年和18年出现了非常晚期的输尿管梗阻。两名患者在输尿管狭窄前1个月和10个月均有排斥反应发作。对其中一条切除的输尿管进行组织学检查，结果强烈提示为排斥反应过程。两名患者均成功接受了开放手术，将输尿管抗反流再植入膀胱，术后观察时间分别为20个月和8个月。我们得出结论，即使在移植多年后，对于肌酐升高和早期肾积水的患者，可能仍需要进行经皮肾造瘘术。
