Diagnosis and Management of Ureteropelvic Obstruction in Kidney Transplant Recipients and Outcomes of Foley Y-V Pyeloplasty


CAYLAN A. E., UÇAR M., GÜRMAN R., KUTLU Ö.

Experimental and Clinical Transplantation, cilt.22, sa.4, ss.277-283, 2024 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 22 Sayı: 4
  • Basım Tarihi: 2024
  • Doi Numarası: 10.6002/ect.2023.0269
  • Dergi Adı: Experimental and Clinical Transplantation
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.277-283
  • Anahtar Kelimeler: End-stage renal disease, Foley Y-V plasty, Kidney transplantation, Ureteropelvic junction
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Objectives: To evaluate the etiology and diagnostic tools for ureteropelvic obstruction in kidney transplant recipients, we investigated the short-term and long-term outcomes of Foley Y-V pyeloplasty. Materials and Methods: We retrospectively reviewed 10 patients who underwent kidney transplant followed by additional interventions to treat obstructive ureteral pathologies between 2016 and 2020. We enrolled 4 patients who had received intervention to treat ureteropelvic obstruction. For these 4 patients, serum creatinine and estimated glomerular filtration rate levels were recorded at baseline, during the symptomatic period, and long-term. In this single-center study, we investigated diagnostic tools and management strategies for ureteropelvic obstruction and assessed performance of Foley Y-V nondis-membered pyeloplasty in kidney transplant recipients. Results: Among 4 patients, graft function (assessed by serum creatinine and estimated glomerular filtration rate) worsened significantly (P = .03) in the symptomatic period of ureteropelvic obstruction in all patients; however, graft function levels improved rapidly to levels similar to baseline (P = .07) after Y-V pyeloplasty. In addition, no statistically significant difference was detected between baseline and long-term graft functions after Y-V pyeloplasty in follow-up (P = .28). Conclusions: Diagnosis and management of ureter-opelvic obstruction in kidney transplant recipients are challenging due to rarity and lack of an ideal management algorithm. There is no specific diagnostic tool to discriminate this pathology from other ureteral pathologies; therefore, a regimen of conventional imaging modalities and diuretic renogram combined with endoscopic evaluation is more reliable. Moreover, nondismembered Foley Y-V pyeloplasty is effective and safe for graft function in the short-term and long-term.