AbstractMaterial and Methods
Data collected from the Invasive Radiology charts on kidney transplant patients undergoing nephrostomy followed by dilatation to treat ureteral stricture. The following parameters were looked at: patient age, type of transplant (live- or deceased-donor), the interval after transplant for diagnosis of stricture, number of procedures, interval between procedures, the rate of UTI and bactermia and length of hospital stay. The success rate was assessed by the freedom from stent after dilatation with long-term preservation of normal graft function. Surgical repair after PTD was considered as a failure.Results
Between 1/2000- 12/2014 twenty seven patients were treated by PTD for ureter stricture after kidney transplantation which makes an incidence of 2%. Lich-Gregoir technique for ureteral-vescical anastomosis was used in 12 patients, JJ stent was placed in 11 patient. Most patients had a distal stricture (25/27). The median number of percutaneous procedures was 2.5: five patients had 1, eight patients had 2, eight patients had 3, five patients had 4, and two patients had 5 procedures. The number of patients with UTI requiring hospitalization was 50%; 3 of them had also bacteremia. The median hospital stay was 32 days. Sixteen patients (59.3%) underwent surgery to finally resolve the problem. Four patients lost their graft at an interval of 4 -70 months after diagnosis of stricture another 3 patient died.Conclusions
Percutaneos dilatation of ureter stricture after transplant is associated with high morbidity and prolonged hospitalization. Surgical revision should be considered at an early stage after failure of one or two sessions of PTD.