Urological complications after kidney transplantation

Czech version

Authors: Ján Breza ml. ^1,2; Róbert Fröhlich ¹; Zuzana Žilinská ¹; Ján Breza st. ¹
Authors‘ workplace: Urologická klinika s Centrom pre transplantácie obličiek Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice Bratislava ¹; Klinika pediatrickej urológie, Národný ústav detských chorôb, Bratislava ²
Published in: Ces Urol 2019; 23(3): 203-220
Category: Review article

Overview

The aim of our work was to analyze urological complications after kidney transplantation at the Urology Department with the Center for Kidney Transplantation in Bratislava and to provide rational guidance for their effective solution.

The authors analyzed complications in a group of 1353 renal transplant patients (of which 95 kidneys were retrieved from living donors). We focused on the occurrence, causes, diagnosis and treatment of complications that have a causal relationship to the reconstructed kidney transplant pathways because they are considered to be the most serious complications after kidney transplantation. They account for about 50% of all surgical complications, may cause significant morbidity and mortality, may lead to a delayed onset of the function as well as to the loss of the transplanted kidney. They may even endanger the patient’s life.

The outcome of kidney transplantation and of the occurrence of urological complications is significantly influenced by the surgical technique of kidney removal and transplantation and by the reconstruction of the urinary tract. During kidney removal, all nerves innervating the kidney are disrupted. In terms of glomerular and tubular function of the kidney, denervation is insignificant and does not adversely affect the transport role of the upper urinary tract. However, denervation of the kidney may change the symptomatology of some diseases or of the post-transplant complications. The transplanted kidney does not hurt, hence the patients do not seek help in time and the diagnostics of complications after kidney transplantation is more demanding and often delayed.

In the form of a review article, the authors offer their experience with the diagnostics and treatment of urological complications after kidney transplantation to the readers of the Czech Urology magazine. The algorithms arise from the authors‘ own clinical experience in renal transplantation at the Department of Urology in Bratislava and express a rational approach to the diagnostics and treatment of urological complications following kidney transplantation.

Keywords:

Renal transplantation – urological complications – treatment algorithms – diagnostic algorithms.

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