The Urological Complications of Renal Transplantation :
An 11-Year-Experience at Ramathibodi Hospital
SOMBOON LEUNGWATTANAKIJ, M.D.*,
WACHIRA KOCHAKARN, M.D.*,
SUCHART CHAIMUANGRAT,M.D.*,
SOPON JIRASIRITHAM, M.D.**,
PONGSAKORN EAMTANAPORN, M.D.**,
PHAITON GOJASENI, M.D., B.S., F.R.C.S.*,
CHAROEN LEENANUPUNTH, M.D.*,
VERASING MUANGMAN, M.D.*
Affiliation : * Division of Urology,
** Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Bangkok 10400,
Thailand.
AbstractFrom February 1986 to December 1996, renal transplantation was performed on 344
patients at Ramathibodi Hospital. The urological complications were retrospectively analyzed
in 335 patients (338 renal transplants), 9 patients were lost to follow-up. There were 227 males
and 108 females with age ranging from 15 to 62 years (mean age 40.28 years). There were 207
cadaveric and 131 living-related graft donors. The ureteroneocystostomy was performed either by
modified Politano-Leadbetter (93 cases) or extravesical technique (245 cases).
There were 23 cases of urological complications : ureterovesical anastomotic leakage 6,
ureteric obstruction 6, vesicoureteric reflux 4, significant bleeding from ureterovesical anasto-
mosis 3, renal infarction with fistulas 2, hydronephrosis due to blood clot retention and swelling
of the anastomosis, requiring temporary double J stenting 2. The analysis was done by dividing
the patients into 3 groups, the first and second groups consisted of 100 cases each and the third
group consisted of 138 cases. The urological complications in the groups were 10 per cent, 9 per
cent and 2.89 per cent respectively. There was a statistically significant difference between the
first two groups combined and the third group in terms of complications (p<0.025). The urological
complications of living-related cases were 9 (6.87%), and of cadaveric cases were 14 (6.76%).
There was no significant difference of the complications between living-related and cadaveric
transplants (p>0.05). The comparative results of the ureteric complications of the extravesical
technique were significantly less than the modified Politano-Leadbetter technique ( 4.49%
vs 10.75%), (p<0.05). In conclusion, the extravesical technique of ureterovesical anastomosis was
superior than the modified Leadbetter-Politano technique in terms of post-operative ureteral com-
plications.
Keywords : Renal Transplantation, Complication
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