Ureteral Complications of Pediatric Renal Transplantation

Christopher D. Morrison, Rachel Shannon, Ilina Rosoklija, Oluwarotimi S. Nettey, Riccardo A Superina, Earl Y Cheng, Edward Ming-luan Gong

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

PURPOSE: Ureteral complications following renal transplantation are more common in children than in adults. We identify potential risk factors for ureteral complications in pediatric patients. MATERIALS AND METHODS: We retrospectively studied a cohort of patients who underwent renal transplantation at Lurie Children's Hospital between 2004 and 2016. We analyzed the associations between patient characteristics, operative factors, graft characteristics and postoperative complications. RESULTS: A total of 224 renal transplantations in 219 patients were identified. Preexisting bladder pathology was present in 25% of cases. Overall rate of ureteral complications was 16%, with symptomatic vesicoureteral reflux being the most common. Ureteral complications were seen significantly more frequently in patients with underlying bladder pathology (26% vs 12%, p = 0.01). Rate of postoperative vesicoureteral reflux in patients with bladder pathology was lower when a urologist performed the reimplantation but the difference was not statistically significant (15% vs 27%, p = 0.35). Urologists were significantly more likely to perform the ureteral anastomosis in patients on clean intermittent catheterization (85% vs 43%, p = 0.004) and in patients with a history of complex bladder reconstruction (75% vs 28%, p <0.001). CONCLUSIONS: Patients with existing bladder pathology are at increased risk for ureteral complications, particularly vesicoureteral reflux. Since pediatric urologists routinely perform ureteral reimplantation in patients with existing bladder pathology, these patients may benefit from a multidisciplinary approach between urology and transplant surgery at renal transplantation.

Original languageEnglish (US)
Pages (from-to)810-814
Number of pages5
JournalThe Journal of urology
Volume201
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Kidney Transplantation
Pediatrics
Urinary Bladder
Vesico-Ureteral Reflux
Pathology
Replantation
Intermittent Urethral Catheterization
Transplants
Urology

Keywords

  • pediatrics
  • replantation
  • transplantation
  • urinary bladder diseases
  • vesico-ureteral reflux

ASJC Scopus subject areas

  • Urology

Cite this

Morrison, Christopher D. ; Shannon, Rachel ; Rosoklija, Ilina ; Nettey, Oluwarotimi S. ; Superina, Riccardo A ; Cheng, Earl Y ; Gong, Edward Ming-luan. / Ureteral Complications of Pediatric Renal Transplantation. In: The Journal of urology. 2019 ; Vol. 201, No. 4. pp. 810-814.
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abstract = "PURPOSE: Ureteral complications following renal transplantation are more common in children than in adults. We identify potential risk factors for ureteral complications in pediatric patients. MATERIALS AND METHODS: We retrospectively studied a cohort of patients who underwent renal transplantation at Lurie Children's Hospital between 2004 and 2016. We analyzed the associations between patient characteristics, operative factors, graft characteristics and postoperative complications. RESULTS: A total of 224 renal transplantations in 219 patients were identified. Preexisting bladder pathology was present in 25{\%} of cases. Overall rate of ureteral complications was 16{\%}, with symptomatic vesicoureteral reflux being the most common. Ureteral complications were seen significantly more frequently in patients with underlying bladder pathology (26{\%} vs 12{\%}, p = 0.01). Rate of postoperative vesicoureteral reflux in patients with bladder pathology was lower when a urologist performed the reimplantation but the difference was not statistically significant (15{\%} vs 27{\%}, p = 0.35). Urologists were significantly more likely to perform the ureteral anastomosis in patients on clean intermittent catheterization (85{\%} vs 43{\%}, p = 0.004) and in patients with a history of complex bladder reconstruction (75{\%} vs 28{\%}, p <0.001). CONCLUSIONS: Patients with existing bladder pathology are at increased risk for ureteral complications, particularly vesicoureteral reflux. Since pediatric urologists routinely perform ureteral reimplantation in patients with existing bladder pathology, these patients may benefit from a multidisciplinary approach between urology and transplant surgery at renal transplantation.",
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Ureteral Complications of Pediatric Renal Transplantation. / Morrison, Christopher D.; Shannon, Rachel; Rosoklija, Ilina; Nettey, Oluwarotimi S.; Superina, Riccardo A; Cheng, Earl Y; Gong, Edward Ming-luan.

In: The Journal of urology, Vol. 201, No. 4, 01.04.2019, p. 810-814.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ureteral Complications of Pediatric Renal Transplantation

AU - Morrison, Christopher D.

AU - Shannon, Rachel

AU - Rosoklija, Ilina

AU - Nettey, Oluwarotimi S.

AU - Superina, Riccardo A

AU - Cheng, Earl Y

AU - Gong, Edward Ming-luan

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Y1 - 2019/4/1

N2 - PURPOSE: Ureteral complications following renal transplantation are more common in children than in adults. We identify potential risk factors for ureteral complications in pediatric patients. MATERIALS AND METHODS: We retrospectively studied a cohort of patients who underwent renal transplantation at Lurie Children's Hospital between 2004 and 2016. We analyzed the associations between patient characteristics, operative factors, graft characteristics and postoperative complications. RESULTS: A total of 224 renal transplantations in 219 patients were identified. Preexisting bladder pathology was present in 25% of cases. Overall rate of ureteral complications was 16%, with symptomatic vesicoureteral reflux being the most common. Ureteral complications were seen significantly more frequently in patients with underlying bladder pathology (26% vs 12%, p = 0.01). Rate of postoperative vesicoureteral reflux in patients with bladder pathology was lower when a urologist performed the reimplantation but the difference was not statistically significant (15% vs 27%, p = 0.35). Urologists were significantly more likely to perform the ureteral anastomosis in patients on clean intermittent catheterization (85% vs 43%, p = 0.004) and in patients with a history of complex bladder reconstruction (75% vs 28%, p <0.001). CONCLUSIONS: Patients with existing bladder pathology are at increased risk for ureteral complications, particularly vesicoureteral reflux. Since pediatric urologists routinely perform ureteral reimplantation in patients with existing bladder pathology, these patients may benefit from a multidisciplinary approach between urology and transplant surgery at renal transplantation.

AB - PURPOSE: Ureteral complications following renal transplantation are more common in children than in adults. We identify potential risk factors for ureteral complications in pediatric patients. MATERIALS AND METHODS: We retrospectively studied a cohort of patients who underwent renal transplantation at Lurie Children's Hospital between 2004 and 2016. We analyzed the associations between patient characteristics, operative factors, graft characteristics and postoperative complications. RESULTS: A total of 224 renal transplantations in 219 patients were identified. Preexisting bladder pathology was present in 25% of cases. Overall rate of ureteral complications was 16%, with symptomatic vesicoureteral reflux being the most common. Ureteral complications were seen significantly more frequently in patients with underlying bladder pathology (26% vs 12%, p = 0.01). Rate of postoperative vesicoureteral reflux in patients with bladder pathology was lower when a urologist performed the reimplantation but the difference was not statistically significant (15% vs 27%, p = 0.35). Urologists were significantly more likely to perform the ureteral anastomosis in patients on clean intermittent catheterization (85% vs 43%, p = 0.004) and in patients with a history of complex bladder reconstruction (75% vs 28%, p <0.001). CONCLUSIONS: Patients with existing bladder pathology are at increased risk for ureteral complications, particularly vesicoureteral reflux. Since pediatric urologists routinely perform ureteral reimplantation in patients with existing bladder pathology, these patients may benefit from a multidisciplinary approach between urology and transplant surgery at renal transplantation.

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KW - replantation

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