RÒ NIỆU QUẢN THẬN GHÉP: KINH NGHIỆM ĐIỀU TRỊ TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objective: To identify the causes and early management of ureteral leaks in kidney transplant recipients. Patients and Research Methods: Clinical descriptions of four patients diagnosed with ureteral leaks through clinical examination and computed tomography scans. Study parameters included age, donor source, time of ureteral leak occurrence, ureteral stent insertion technique, immunosuppressive regimen, laboratory tests, treatment, and post-transplant outcomes.Results: Among the four patients with ureteral leaks, three received kidneys from living donors and one received a kidney from a deceased donor. Ureteral leaks occurred on postoperative days 1, 4, and 30, respectively. All patients underwent ureteral stent insertion into the bladder. The cause of the ureteral leaks was identified as ureteral injury due to direct trauma resulting in perforation. Urine creatinine levels were consistent with blood levels, and CT scans clearly visualized the site of the leak. Treatment involved re-suturing the transplanted kidney ureter to the native ureter. Kidney function returned to normal, and no signs of infection were observed. Conclusion: Ureteral leaks require early surgical intervention upon detection to avoid conservative treatments such as JJ stent placement or peritoneal drainage.