Early aggressive management for the prevention of renal allograft loss and patient mortality following major urologic complications

In 219 renal allograft transplants performed at the University Hospital, State University of New York at Stony Brook, 24 urological complications were encountered (10.8%). There were 12 episodes of ureteral obstruction and 8 of ureteral fistulas with extravasation. Four patients had bladder fistulas. In all patients, early surgical corrective procedures were employed. No graft or patient losses occurred as a result of these complications or of their treatment (0% mortality; 0% graft loss). Based on this as well as others' experience (1-24), it appears that early aggressive diagnosis and surgical treatment, combined with urological expertise, are a central requirement for the avoidance of graft loss or mortality following urological complications.