1Hassan Alqarni,2Abdullah Linjawi, 1Abdullah Linjawi, 1Dalia Alshear, 1Almamoon I Justaniah, 1Almamoon I Justaniah, 1Majed Ashour

1KFSH&RC, Jeddah, 2East Jeddah Hospital

Objective:

The prevalence of urologic complications after renal transplant ranges from 2.6 – 13%, which can result in graft loss. The aim of this study is to assess the safety and efficacy of interventional radiology procedures for urologic complications post renal transplant.

Material(s) and Method(s):

1000 consecutive renal transplant patients were retrospectively reviewed at our institution from January 2016 till October 2021. Patients with no urologic complications were excluded. Clinical and procedural records were reviewed for patients with nonvascular urologic complications whom required procedures by Interventional Radiology. Technical and clinical success rates, as well as complications, were recorded.

Result(s):

35/1000 (3.5%) patients had non vascular urologic complications (ureteric obstruction 31/35 (88%), urinary leak 4/35 (11%). Mean time for manifestation of leak and obstruction was 7 days and 3.3 years, respectively. Mean follow up was 43.3 months ( (Range from 4-102 months). All patients underwent nephrostomy placement (100%),while ureteric stents were placed in 34/35 (97%) patients, ureteroplasty was performed in 13/35 (37%) patients. Technical success was 100% for nephrostomy and 97% for ureteric stent placement. 94% of patients demonstrated clinical success by eGFR improvement in 5-7 days. 2/35 (5%) patients had renal pelvis perforation which was managed conservatively. 4/35 (11%) patients lost their grafts due to prolonged obstruction 2/35 (5%), and rejection 2/35 (5%).

Conclusion(s):

Interventional radiology procedures are safe and effective in managing non-vascular urologic complications in renal transplant patients.