The utility of native ureter in the management of ureteral complications in children after renal transplantation

• DOI: 10.1111/petr.14051
• Publication Date: 2021-05-31T04:23:22Z
• Authors: Emily C. Serrell; Ruthie Su; Fardod O'Kelly; Michael Semanik; Walid A. Farhat
• Keywords: Balloon dilation

Ureteral complications after renal transplantation in children are a major source of morbidity. Management is complex and variable.With IRB approval, health records were retrospectively reviewed patients who: <18 years, underwent kidney transplant between 1997 2017, had at least 2 years follow-up, interventions due to post-transplant ureteral complications.Of 136 patients, seventeen (13%) required intervention stricture (n = 3), reflux 12), or both 2). Transplant occurred median 10.5 (3.1-14.7). Reconstruction 10 months (7-15) transplant. Pre-existing bladder pathology was present 6 (35%) patients. Four five with strictures one endoscopic balloon dilation. Ultimate management included reimplantation, ureteroureterostomy native ureter, pyeloureterostomy multiple followed by Boari flap, failed interventions. Fourteen VUR reimplantation 5), ureter 4), injection Deflux the ureter. Only patient non-functioning graft complication. All alive follow-up (median 17 [12-19]).Transplant significant following pediatric may require surgical management. In our population, requiring reconstruction 10% 4%, respectively. Endoscopic rarely successful. Native ureters used for more than two thirds should be considered complications.