Objective: Since 1989 the percentage of living-related donor renal transplantations has increased considerably at our institution. We compared the incidence of urological complications in the living-related donor transplantation(LRDT) group and the cadaveric donor transplantation (CDT) group. Methods:Between September 1989 and September 1994, 534 consecutive patients underwent a renal transplantation. During that period, the percentage of LRDT increased from 10 to 25 (mean: 14.8) per year. In all patients a transvesical ureteroneocystostomy without antireflux mechanism was performed. Results: A urological complication developed in 64 (11.9%) of the recipients(obstruction in 6.3%; leakage in 5.6%). In 41 (7.7%) patients the complication was transitory and could be managed with minimal invasive measures such as a percutaneous nephrostomy (n = 34), drainage of a paraurethral fluid collection(n = 13), transurethral bladder drainage (n = 3) or a combination of these. In 23 (4.3%) of the recipients a secondary urological intervention such as a pyeloureterostomy (n = 21) or percutaneous dilatation of a ureteral stricture was necessary. The incidence of obstruction was equal in the LRDT and CDT groups, whereas leakage was more frequently encountered in the LRDT group(11.4 vs. 4.6%, p < 0.05). Transplant survival after 1 year was significantly better in the LRDT group than in the CDT group (97 vs. 77%, p < 0.001). Conclusion: The risk of leakage is higher in living-related donor kidney transplantations. Urological complications, however, do not impair graft survival.

Keywords:
Renal transplantation, Urological complications, Ureteral obstruction, Urinary leakage, Living-related donor transplantations
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1997
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