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Ureteric complications in recipients of kidneys from donation after circulatory death donors
Author(s) -
Mah TrinaJo,
Mallon Dermot H.,
Brewster Oliver,
SaebParsy Kourosh,
Butler Andrew J.,
Bradley J. Andrew,
Kosmoliaptsis Vasilis
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12912
Subject(s) - medicine , incidence (geometry) , kidney transplantation , surgery , urinary system , kidney , transplantation , urology , physics , optics
A large increase in the use of kidneys from donation after circulatory death ( DCD ) donors prompted us to examine the impact of donor type on the incidence of ureteric complications ( UC s; ureteric stenosis, urinary leak) after kidney transplantation. We studied 1072 consecutive kidney transplants ( DCD n=494, live donor [ LD ] n=273, donation after brain death [ DBD ] n=305) performed during 2008‐2014. Overall, there was a low incidence of UC s after kidney transplantation (3.5%). Despite a trend toward higher incidence of UC s in DCD (n=22, 4.5%) compared to LD (n=10, 3.7%) and DBD (n=5, 1.6%) kidney transplants, donor type was not a significant risk factor for UC s in multivariate analysis ( DCD vs DBD HR : 2.33, 95% CI : 0.77‐7.03, P =.13). There was no association between the incidence of UC s and donor, recipient, or transplant‐related characteristics. Management involved surgical reconstruction in the majority of cases, with restenosis in 2.7% requiring re‐operation. No grafts were lost secondary to UC s. Despite a significant increase in the number of kidney transplants from DCD donors, the incidence of UC s remains low. When ureteric complications do occur, they can be treated successfully with surgical reconstruction with no adverse effect on graft or patient survival.