A Single-Centre Study on the Diagnosis and Management of Transplant Ureteric Strictures: An 11 Year Experience
1Department of Renal Transplantation, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom, 2NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
Meeting: 2022 American Transplant Congress
Abstract number: 293
Keywords: Post-operative complications
Topic: Clinical Science » Kidney » 41 - Kidney Technical
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 6:20pm-6:30pm
Location: Hynes Room 312
*Purpose: The optimal management of transplant ureteric stricture is unclear. This study presents a single-centre’s 11-year experience of the diagnosis and management of these cases.
*Methods: All transplant patients who had a nephrostomy inserted for transplant dysfunction and pelvicalyceal dilatation on ultrasound between January 2010- December 2020 were identified. Details of diagnosis, management and outcomes of their obstruction were collected from electronic case records.
*Results: 63 of 1143 (5.5%) transplant patients presented with obstructive uropathy during the study period (mean age 49 years; 73% male). 14 patients had had a previous transplant. 3 had ileal conduits. 1 and 5 year graft survival was 96% and 70% respectively.
54 patients had a mechanical cause of their obstruction (48 stricture, 2 calculi, 2 clot, 1 malignancy; 1 collection). 43 (79.6%) presented within a year of transplantation. Definitive management was a success in 85% of cases.
Of the 48 with strictures, 68.8% were distal ureteric. The majority (79.2%) underwent antegrade stenting as their primary intervention. 26 patients had definitive treatment of surgical reimplantation, of which 19 (73.1%) of these were immediately successful. Of the remainder, 6 were ultimately successful with either retrograde stenting (3), further operative intervention (2) or long term nephrostomy (1). 1 patient developed a severe fungal infection after multiple operations and lost their graft. 7 patients (14.6%) had definitive treatment of retrograde stenting, with only one being unsuccessful and requiring a long term nephrostomy. 2 had balloon ureteroplasty and 2 required no further treatment. 10 patients (20.8%) lost their graft through non-obstructive causes e.g. rejection before definitive treatment was provided.
*Conclusions: This is a complex group of patients that require a range of operative/interventional strategies to achieve success. Often a single intervention is not enough, highlighting a need for a multi-disciplinary approach. Despite this, overall graft outcomes are good.
To cite this abstract in AMA style:
Norton WG, Aitken E, Clancy M, Murio E, Gillis K. A Single-Centre Study on the Diagnosis and Management of Transplant Ureteric Strictures: An 11 Year Experience [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/a-single-centre-study-on-the-diagnosis-and-management-of-transplant-ureteric-strictures-an-11-year-experience/. Accessed May 28, 2025.« Back to 2022 American Transplant Congress