Management of non-vascular complications following renal transplantation using percutaneous approach

Abstract

OBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation.

PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study.

RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephro- sis secondary to ureteral stricture (n. 15), clinical symptom-producing lymphocele due to pressure (14) and creatinine ele- vated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and dou- ble-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 ± 2.84mg/dL and 2.17 ± 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-proce- dural creatinine values were 2.97 ± 1.78 mg/dL and 1.75 ± 1.18 respectively (p=0.002), indicating a significant dif- ference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 ± 2.36 mg/dL and 2.57 ± 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference.

CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.