Abstract
Despite the remarkable improvement in the results of renal transplantation during the last decade, surgical and medical complications continue to contribute significantly to the morbidity and mortality of allograft recipients. Moreover, in live-donor renal transplantation the risks to living donors are small, but real. The objective of the present chapter is to review the complications that may affect the safety of both the donors and recipients as well as the efficacy of the graft. A special emphasis on the surgical complications in both the donors and recipients will be done. Other medical problems that may interfere with the proper diagnosis and prompt management of surgical emergencies will be discussed shortly.
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References
Artero ML, Sharma R, Savin VJ, Vincenti F (1994) Plasmapheresis reduces proteinuria and serum capacity to injure glomeruli in patients with recurrent focal glomerulosclerosis. Am J Kidney Dis 25:574
Baghossian T, Henri M, Dube S, Bendavid Y, Morin M (2005) Laparoscopic nephrectomy donor death due to cerebral gas embolism in a specialized transplant center; risk zero does not exist. Transplantation 79:258
Bakir N, Sluiter WJ, Ploeg RJ, van San WJ, Tegzess AM (1996) Primary renal graft thrombosis. Nephrol Dial Transplant 11:140
Benoit G, Jaber N, Moukarzel M, Douguet D, Bensadoun D, Bensadoun H, Blanchet P et al (1994) Incidence of vascular complications in kidney transplantation: is there any interference with the nature of the perfusion solution? Clin Transplant 8:485
Blohme I, Fehrman I, Norden (1992) Living donor nephrectomy complication rates in 490 consecutive cases. Scand J Urol Nephrol 26:149
Boedker A, Roikjaer O, Rasmussen F, Loekkegaard H (1990) Lymphocele following renal transplantation: a clinical study. Transplant Proc 22:54
Broyer M, Gognadoux MF, Sierro A, Fischer AH, Niaudet P (1991) Preventive treatment of vascular thrombosis after kidney transplantation in children with low molecular weight heparin. Transplant Proc 23:1384
Cimic J, Meuleman EJH, Oosterhof GON, Hoitsma AJ (1997) Urological Complications in renal transplantation: a comparison between living-related and cadaveric grafts. Eur Urol 31:433
Dean PG, Lund WJ, Larson TS, Prieto M, Nyberg SL, Ishitani MB et al (2004) Wound-healing complication after kidney transplantation: a prospective randomized comparison of sirolimus and tacrolimus. Transplantation 77:1555
El-Mekresh M, Osman Y, Ali-El-Dein B, El-Diasty T, Ghoneim MA (2001) Urological complications after living-donor renal transplantation. BJU Int 87:295
European Mycophenolate Mofetil Study Group (1995) Placebo-controlled study of mycophenolate mofetil combined with cyclosporine and corticosteroids for prevention of acute rejection. Lancet 345:1321
Garret ED Jr, Groshart K, Duvall-Seaman D, Combs D, Stuggs R (2002) Treatment of humoral rejection with rituximab. Ann Thorac Surg 74:1240
Ghasemian SMR, Guleria AS, Khawand NY, Light JA (1996) Diagnosis and management of the urologic complications of renal transplantation. Clin Transplant 10:218:23
Groggel GC (1991) Acute thrombosis of the renal transplant artery: a case report and review of the literature. Clin Nephrol 36:42
Halimi JM, Al-Najjar A, Buchler M, Birmele B, Tranquart F, Alison D et al (1999) Transplant renal artery stenosis: potential role of ischemia renal reperfusion injury and long-term outcome following angioplasty. J Urol 161:28
Hardinger KL, Brennan DC, Lowell J, Schnitzer MA (2004) Long-term outcome of gastrointestinal complications in renal transplant patients treated with mycophenolate mofetil. Transpl Int 17:609
Huynth PN, Hollander JB (2005) Trends toward laparoscopic nephrectomy at a community hospital. J Urol 173:547
Jacobs SC, Cho E, Foster C, Liao P, Bartlett ST (2004) Laparoscopic donor nephrectomy: the university of Maryland 6-year experience. J Urol 171:47
Kaplan AA (1999) Therapeutic apheresis for renal disorders. Ther Apher 3:25
Kaplan AA (2003) The use of apheresis in immune renal disorders. Ther Apher 7:165
Kaplan BS, Meyers KE, Schulman SL (1998) The pathogenesis and treatment of hemolytic uremic syndrome. J Am Soc Nephrol 9:1126
Katz JP, Greensstein M, Hakki A, Miller A, Katz SM, Simonian S (1988) Transitional epithelial lesions of the ureter in renal transplant rejection. Transplantation 45:710
Kyriakides GK, Simmons RL, Najarian JS (1979) Mycotic aneurysms in transplant patients. Arch Surg 111:472
Land W (1998) Postischemic reperfusion injury and kidney transplantation: prologue. Transplant Proc 30:4210
Lo CY, Chang IK, Tso WK, Mak KO (1996) Percutaneous transluminal angioplasty for transplant renal artery stenosis. Transplant Proc 28:1468
Loauad I, Buchler M, Noel C, Sadek T, Maazouz H, Westeel PF, Lebranchu Y (2005) Renal artery aneurysm secondary to Candida albicans in four kidney allograft recipients. Transplant Proc 37:2834
Loughlin KR, Tilney NL, Richie JP (1984) Urologic complications in 718 renal transplant patients. Surgery 95:296
Makisalo H, Eklund B, Salmela K et al (1997) Urological complications after 2084 consecutive kidney transplantation. Transplant Proc 29:152
Matas AJ, Bartlett ST, Leichtman AB, Delmonico FL (2003) Morbidity and mortality after living kidney donation, 1999 survey of United States transplant centers. Am J Transplant 3:830
Meyers AM, Levine E, Myburgh JA, Goudie E (1977) Diagnosis and management of lymphoceles after renal transplantation. Urology 10:497
Mohan P, Murphy DM, Counihan A, Cunningham P, Hickey DP (1999) The role of intraoperative heparin in cyclosporine treated cadaveric renal transplant recipients. J Urol 162:682
Murphy BG, Hill C, Middleton D, Deherty CC, Brown JH, Nelson WE et al (1994) Increased renal allograft thrombosis in CAPD patients. Nephrol Dial Transplant 9:1166
Najarian JS, Chavers BM, McHugh LE, Matas AJ (1992) 20 years ormore of follow-up of living kidney donors. Lancet 340:807
Osman Y, Shokeir A, Ali El-Dein B, Tantawy M, Wafa EW, Shehab El-Dein AB, Ghoneim MA (2003) Vascular complications after live donor renal transplantation: study of risk factors and effects on graft and patient survival. J Urol 169:859
Pescovitz MD (2004) The use of rituximab, anti-CD20 monoclonal antibody, in pediatric transplantation. Pediatr Transplant 8:9
Pirsch JD, Friedman R (1994) Primary care of the renal transplant patient. J Gen Intern Med 9:29
Ratner LE, Montgomery RA, Kavoussi LR (1999) Laparoscopic live donor nephrectomy: the four years John Hopkins University experience. Nephrol Dial Transplant 14:2090
Rawlins MC, Hefty TL, Brown SL, Biehl TR (2002) Learning laparoscopic donor nephrectomy safety: a report on 100 cases. Arch Surg 137:531
Rigg KM, Proud G, Taylor RM (1994) Urological complications following renal transplantation: a study of 1016 consecutive transplants from a single center. Transplant Int 7:120
Sanchez de la Nieta MD, Sanchez-Fructuoso AI, Alcazar R, Perez-Contin MJ, Prats D, Grimalt J, Blanco J (2004) Higher graft salvage rate in renal allograft rupture associated with acute tubular necrosis. Transplant Proc 36:3016
Schweizer RT, Bartus SA, Kahn CS (1977) Fibrosis of a renal transplant ureter. J Urol 117:125
Shahrokh H, Rasouli H, Zargar MA, Karimi K, Zargar K (2005) Spontaneous kidney allograft rupture. Transplant Proc 37:3079
Shokeir AA, El-Diasty TA, Ghoneim MA (1993a) Endouroligic management of ureteric complications after live-donor kidney transplantation. J Endourol 7:487
Shokeir AA, El-Diasty TA, Ghoneim MA (1993b) Percutanous treatment of lymphocele in renal transplant recipients. J Endourol 7:481
Shokeir AA, Shamaa MA, Bakr MA, El-Diast TA, Ghoneim MA (1993c) Salvage of difficult transplant urinary fistulae by ileal substitution of the ureter. Scand J Urol Nephrol 27:537
Shoskes DA, Cecka JM (1997) Effect of delayed graft function on short and long-term kidney graft survival In: Clinical Transplant (JM Cecka and PL Terasaki, eds) P 297, UCLA Tissue Typing Laboratory. Los Angeles
Sollinger HW (1995) for the US Renal Transplant Mycophenolate Mofetil Study Group. Mycophenolate mofetil for the prevention of acute rejection in primary cadaveric renal allograft recipients. Transplantation 60:225
Stephenian E, Matas AJ, Gores P (1992) Sutherland DER, Najarian JS Retransplantation as a risk factor for lymphocele formation. Transplantation 53:676
Sutherland RS, Spees EK, Jones JW, Fink DW (1993) Renal artery stenosis after renal transplantation: The impact of the hypogastric artery anastomosis. J Urol 149:980
The Tricontinental Mycophenolate Mofetil Renal Transplantation Study Group (1996) A blinded, randomized clinical trial of mycophenolate mofetil for the prevention of acute rejection on cadaveric renal transplantation. Transplantation 61:1029
Troppmann C, Pierce JL, Gandhi MM, Gallay BJ, McVicar JP, Perez RV (2003) Higher surgical wound complication rates with sirolimus immunosuppression after kidney transplantation: A matched-pair pilot study. Transplantation 76:426
Ubhi CS, Lam FT, Mavor AI, Giles GR (1989) Subcutaneous heparin therapy for cyclosporine-immunosupprised renal allograft recipients. Transplantation 48:886
Van Lieburg AF, de Jong MC, Hoitsma AJ, Buskens FG, Schroder CH, Monnens LA (1995) Renal transplant thrombosis in children. J Pediatr Surg 30:615
Vastag B (2003) Living-donor transplants reexamined: Experts cite growing concerns about safety of donors. JAMA 290:181
Veroux M, Veroux P, Puliatti C, Fiamingo P, Macarone M, Cappello D (2003) Renal allograft rupture caused by acute tubular necrosis. Chir Ital 55:753
Zaontz MR, Hatch DA, Firlit CF (1988) Urological complications in pediatric renal transplantation: Management and prevention. J Urol 140:1123
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Ghoneim, M.A., Shokeir, A.A. (2007). Emergencies Following Renal Transplantation. In: Hohenfellner, M., Santucci, R.A. (eds) Emergencies in Urology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-48605-3_32
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DOI: https://doi.org/10.1007/978-3-540-48605-3_32
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