Early urologic complications after pediatric renal transplant: a single-center experience.

Abstract:

BACKGROUND:Urologic complications cause substantial morbidity in the pediatric population after renal transplantation, but their impact on graft survival and transplant costs is poorly understood. In this retrospective review, we evaluated the records of all pediatric renal transplant recipients at our center from 1995 to 2004. METHODS:Patient demographics, presence of urinary leak, stricture, compression, or vesicoureteral reflux, and hospital costs were analyzed. Univariable analysis identified predictors of complications and of need for reoperation, and Kaplan-Meier analysis was used to assess graft survival in relation to urinary complications. RESULTS:One hundred forty-seven children received renal transplants; mean follow-up was 1478+/-965 days. Nine (6.1%) patients had urologic complications and seven (4.8%) patients developed vesicoureteral reflux requiring reoperation. Sex, ischemia time, race, previous transplant, donor type, nephrectomy technique, and stent use did not affect the incidence of urologic complications. Previous urologic reconstruction and pretransplant ureteral pathologic conditions increased the risk of urologic complication and vesicoureteral reflux. Patients with urologic complications had equivalent graft survival, but triple the hospital costs of unaffected recipients. CONCLUSIONS:Prior urologic surgery is associated with increased risk of urologic complications posttransplant. Posttransplant urologic complications are associated with substantially increased costs in the first year after transplant, but not with decreased graft survival.

journal_name

Transplantation

journal_title

Transplantation

authors

Englesbe MJ,Lynch RJ,Heidt DG,Thomas SE,Brooks M,Dubay DA,Pelletier SJ,Magee JC

doi

10.1097/TP.0b013e31818b63da

subject

Has Abstract

pub_date

2008-12-15 00:00:00

pages

1560-4

issue

11

eissn

0041-1337

issn

1534-6080

pii

00007890-200812150-00013

journal_volume

86

pub_type

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