LATE URETERAL OBSTRUCTION AFTER KIDNEY-TRANSPLANTATION - FIBROTIC ANSWER TO PREVIOUS REJECTION

Today, the incidence of urological complications following renal trans plantation is 2 %-10 %. Most of these complications occur within the 1 st year and affect the distal ureter. We report on two patients who de veloped very late ureteral obstruction, 14 and 18 years after transpla ntation. Both patients had rejection episodes 1 and 10 months prior to the ureteral stenosis. Histological examination of one resected urete r revealed findings strongly suggestive of a rejection process. Open s urgery with antirefluxive reimplantation into the bladder was successf ul in both patients, with a postoperative observation time of 20 and 8 months, respectively. We conclude that a percutaneous nephrostomy may be required in patients with rising creatinine and incipient hydronep hrosis even long after transplantation has been performed.