Whose Transplant Function Fails After Ureteral Revision Following Kidney Transplantation?

Background: Kidney transplantation is associated with ureteral complications in about 5% of cases. While many reasons for ureteral complications are known, it is currently unknown whether transplant outcomes are affected by operative revision of the transplanted ureter. In a retrospective analysis, we compared patients with versus without loss of transplant function after operative revision for a ureteral complication. Patients and methods: Between 1997 and 2005, a total of 43 ureteral complications occurred in 636 patients (6.8%) after kidney transplantation. Thirty-one of 43 patients underwent open operative revision of the transplant ureter. One patient died from suicide. The remaining 30 patients were analyzed for clinical parameters and transplant outcome. Results: At median 5-year follow-up, 18/30 patients (60%) had functioning transplants and 12/30 (40%) had returned to dialysis. Various parameters such as number of mismatches, ischemia times, number of previous transplantations, and interval from transplantation to occurrence of ureteral complication as well as posttransplant and postrevision serum creatinine values showed no influence on transplant outcomes. Conclusions: In our retrospective analysis, transplant outcome was not affected by specific parameters associated with operative revision of the transplant ureter.