In this study we report the ureteral complication based on urologist's experience for ureteral reimplantation with two different spatulation lengths. From September 2005 to June 2008, 170 kidney transplant recipients studied and their ureteral complications were analysed .In all patients the ureter from the kidney graft was extravesically implanted described by Lich-Gregoir with using double j stent at least for 6 weeks. Patients divided in two groups 70 recipients were in group 1 and ureteral spatulation length in this group was between 5-8mm in group 2 ( 100 recipients) ureteral spatulation was 9mm or more (9-14mm) during follow-up ureteral complications evaluated and compared between two groups . Before and after removing double j stent ( 6 weeks later ) ureteral complication's that needed surgical intervention ( open or percutaneous) occurred in 16/70 recipients in group 1 ( 20.3%) and in 11/100 recipients in group 2 (11%). Urine leakage and ureteral obstruction were the most frequent. The time of occurrence was either short ( <6weeks) or late (> 6 weeks). Most cases needed percutaneous nephrostomy (PCN) and some of them managed later by open surgery, no deaths related to any of the urological complication were reported during the follow-up ( mean time 13 months) . In conclusion, to reduce ureteral complications in kidney transplant recipients we recommend enough ureteral spatulation length ( 9 mm or more).
Volume : 6
Issue : 4
Pages : 46
Mashad Transplant Center, Ghaem Hospital, Mashad University of Medical Sciences, Mashad, Iran