Native ureteropyelostomy: an effective therapy for urinary tract complications following kidney transplantation

Background: Urinary tract complications are relevant sources of morbidity and mortality after kidney transplantation. Incidence is reported within 3-14% in recent studies. Secondary ureteropyelostomy using the native ureter is a surgical option to treat severe urinary tract complications after kidney transplantation. The aim of this study was to evaluate the outcome after ureteropyelostomy using the native ureter in the management of urinary tract complications after kidney transplantation. Methods: A single centre, retrospective clinical review of prospectively collected data of all patients who received kidney transplantation or combined kidney-pancreas transplantation between January 2001 and June 2009 was performed. All patients who underwent surgical therapy for urinary tract complications were identified and followed up to evaluate graft function and survival. Results: Six hundred forty-six patients received kidney transplantation or combined kidney/pancreas transplantation. Twenty-six patients (4%) had to undergo re-operation due to severe urinary tract complications after kidney transplantation. Sixteen of the 26 patients (62%) received ureteropyelostomy using the ipsilateral native ureter. This reconstructive operation was successful in 14 of 16 patients (87.5%). Two patients needed to be re-operated for surgical complications. Conclusion: Ureteropyelostomy using the native ureter to treat ureter-related urinary tract complications after kidney transplantation can be performed safely and result in good graft and patient survival.