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Churchill BM, Sharma A, Aziz D, Halawa A. Identifying Early Extraperitoneal High-Volume Urine Leak Post Kidney Transplantation. EUROPEAN MEDICAL JOURNAL 2021. [DOI: 10.33590/emj/20-00213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Transplant clinicians need to be watchful of several potential surgical complications in the early post-transplant period, including haemorrhage, extraperitoneal urine leak, and lymphocele. While haemorrhage and extraperitoneal urine leak usually present in the early post kidney transplant period, lymphoceles usually present 2–6 weeks after transplantation. While the colour and volume of the drained fluid can give some indication of the problem, is not enough evidence for a confident urine leak diagnosis. Further investigations, such as serum biochemical parameter analysis of the drained fluid and ultrasonography, help to identify the true cause. This paper discusses how to identify high-volume extraperitoneal urine leaks in the early post kidney transplant period and considers the differential diagnoses. Different ureteroneocystostomy procedures, including the Lich–Grégoir, Politano–Leadbetter, and U-stitch techniques, are discussed and compared regarding complication rates (especially urine leak and haematuria). The authors also address the management of low- and high-volume extraperitoneal urine leak, the follow-up needed, and the impact of urine leak on graft and patient survival, length of hospital stay, and rate of hospital readmission.
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Affiliation(s)
| | - Ajay Sharma
- Postgraduate Education in Transplantation, University of Liverpool, Liverpool, UK; Department of Transplantation, Liverpool University Teaching Hospitals NHS Foundation Trust, Liverpool, UK
| | - Davis Aziz
- School of Medicine, University of Liverpool, Liverpool, UK
| | - Ahmed Halawa
- Postgraduate Education in Transplantation, University of Liverpool, Liverpool, UK; Sheffield Kidney Institute, Sheffield Teaching Hospitals, Sheffield, UK
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