Background: Our aim is to identify the incidence of urologic complications in adult renal transplantation comparing two different ureterovesical anastomosis techniques, the Taguchi (T) and Lich-Gregoire (LG).
Material/methods: Retrospective analysis of adult renal transplants performed at the MUHC between 2000-2009. Excluded: multi-organ transplants, re-do transplants, variant ureteric anastomosis and patients received grafts from UNOS ECD. 372 patients were analyzed. 209 patients (56%) in the T group and 163 patients (44%) in the LG group. Fisher's exact test was used to compare the groups for urologic complications. A multivariate analysis was performed to identify factors associated with graft rejection and death.
Results: 21 patients developed a urinary leak or stricture. A total of 13 patients (3.4%) developed ureteric strictures and 9 (2.4%) patients developed urinary leak with no difference in urinary leak or stricture between both groups (p=1). Hematuria requiring intervention developed in 55 patients. A higher incidence of complicated hematuria in the T group when compared to the LG group (37 vs. 18, p=0.079)). No differences in other ureteric complications between the 2 groups. Delayed graft function OR=3.4 (95% CI=1.8-6.3) and grafts from a deceased donors OR=2.2 (95% CI=1.1-4.5) are factors associated with graft loss. Factors associated with first episode of rejection include delayed graft function OR=2.4 (95% CI=1.3-4.4), and the development of ureteric stricture OR=3.9 (95% CI=1.8-8.7).
Conclusions: Both techniques can be used interchangeably for adult renal transplantation. T technique is associated with a greater risk of hematuria. Ureteric strictures are associated with a shorter time to first graft rejection.
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http://dx.doi.org/10.12659/aot.881999 | DOI Listing |
Surg Radiol Anat
January 2025
Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, 286-8520, Chiba, Japan.
Purpose: We present the case of a rare extrahepatic portocaval shunt that resulted in communication of the portal vein and the inferior vena cava (IVC) at the level between two right renal veins that was incidentally diagnosed with contrast-enhanced computed tomography (CECT) in an asymptomatic patient.
Methods: A woman in her sixties with abdominal pain and diarrhea of unclear origin underwent exploratory abdominal CECT.
Results: The CECT incidentally revealed an extrahepatic portocaval shunt, whereby a vessel arising from the portal vein superior to the confluence of the superior mesenteric and splenic veins drained into the posterior aspect of the IVC between two right renal veins.
Pediatr Transplant
March 2025
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Background: Some adult transplant surgeons consider transplant to be contraindicated in patients receiving palliative care (PC). Little is known about pediatric transplant surgeons' attitudes toward PC. We sought to ascertain pediatric kidney transplant surgeons' perspectives regarding the routine integration of PC for children with chronic kidney disease.
View Article and Find Full Text PDFJ Ren Care
March 2025
Department of Emergency and Critical Care Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Background: Kidney failure is a major health issue globally, particularly in Ghana and other low- and middle-income countries. Nurses are centrally involved in the direct care and technical operations of managing individuals with kidney failure, and they have first-hand exposure to the complexities of kidney failure management, including haemodialysis within resource-constrained settings.
Objective: This study explored the experiences of nurses who provide care to individuals with kidney failure receiving haemodialysis in Ghana.
J Ren Care
March 2025
School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia.
Background: Globally, haemodialysis is the most frequent type of kidney replacement therapy and necessitates access to the bloodstream either through a native arteriovenous fistula, arteriovenous graft or central venous catheter. Vascular access complications are a major cause of morbidity and mortality in adults receiving haemodialysis, and effective vascular access self-management is required.
Objective: To examine the effectiveness of educational or behavioural interventions designed to improve self-management of long-term vascular access in adults receiving haemodialysis.
Int Angiol
December 2024
Department of Radiology, Faculty of Medicine, Kastamonu University, Kastamonu, Türkiye.
Background: An effectively functioning arteriovenous fistula (AVF) is vital for end-stage renal disease patients. This study aims to evaluate the effects of Fogarty balloon catheter dilation on creating an effectively functioning AVF.
Methods: This retrospective cohort study was conducted at our clinic between 2020 and 2022.
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