Ureteric complications in recipients of kidneys from donation after circulatory death donors
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Mah, T., Mallon, D., Brewster, O., Saeb-Parsy, K., Butler, A., Bradley, J., & Kosmoliaptsis, V. (2017). Ureteric complications in recipients of kidneys from donation after circulatory death donors. Clinical Transplantation, 31 https://doi.org/10.1111/ctr.12912
A large increase in the use of kidneys from donation after circulatory death (DCD) donors prompted us to examine the impact of donor type on the incidence of ureteric complications (UCs; ureteric stenosis, urinary leak) after kidney transplantation. We studied 1072 consecutive kidney transplants (DCD n=494, live donor [LD] n=273, donation after brain death [DBD] n=305) performed during 2008-2014. Overall, there was a low incidence of UCs after kidney transplantation (3.5%). Despite a trend toward higher incidence of UCs in DCD (n=22, 4.5%) compared to LD (n=10, 3.7%) and DBD (n=5, 1.6%) kidney transplants, donor type was not a significant risk factor for UCs in multivariate analysis (DCD vs DBD HR: 2.33, 95% CI: 0.77-7.03, $P$=.13). There was no association between the incidence of UCs and donor, recipient, or transplant-related characteristics. Management involved surgical reconstruction in the majority of cases, with restenosis in 2.7% requiring re-operation. No grafts were lost secondary to UCs. Despite a significant increase in the number of kidney transplants from DCD donors, the incidence of UCs remains low. When ureteric complications do occur, they can be treated successfully with surgical reconstruction with no adverse effect on graft or patient survival.
This study was supported by the Cambridge NIHR Biomedical Research Centre and the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation at the University of Cambridge in collaboration with Newcastle University and in partnership with NHS Blood and Transplant (NHSBT). VK was supported by an Academy of Medical Sciences Grant and an Evelyn Trust Grant. DHM was supported by a RCSEng Research Fellowship.
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External DOI: https://doi.org/10.1111/ctr.12912
This record's URL: https://www.repository.cam.ac.uk/handle/1810/263311