Objective To determine the incidence and management of urological complicat
ions after 1200 consecutive live-donor renal transplantations, all of which
were carried out in one centre; the possible risk factors and the effect o
n patient and graft survival were also assessed.
Patients and methods Data were retrieved from an electronic database; the i
ncidence of urological complications was determined, and correlated with re
levant risk factors by univariate and multivariate analysis. The effect on
patient and graft survival was assessed using Kaplan-Meier statistics.
Results There were 100 complications in 96 patients (8%); urinary leaks occ
urred in 37, ureteric strictures in 23 and lymphoceles causing ureteric obs
truction in 17. Percutaneous needle biopsy was complicated by haematuria an
d clot anuria in six patients, Late complications included 11 cases of ston
es, four of bladder malignancy and two of haemorrhagic cystitis. There was
evidence that the age of the recipients (<10 years), method of establishing
urinary continuity (uretero-ureteric anastomosis) and a high dose of stero
ids had an independent positive effect on the incidence of urological compl
ications, However, their development did not influence graft or patient sur
vival.
Conclusion When there is meticulous attention to the technical details, ren
al transplantation should incur few urological complications. Early interve
ntion with percutaneous drainage reduces morbidity and the likelihood loss
of graft function. Proper and prompt management should not affect the graft
and/or the patient's survival.