[Surgical treatment in complications of renal transplantation]

The increasing number of renal transplantations in Bulgaria and the increased survival rate of renal transplantation patients lead to an increase of the number of complications (vascular, urological, liquid collections) requiring surgical intervention. One hundred and ninety renal transplantation patients have been treated in the Department of Renal Transplantation for the period 1997-2003. Of these 12 were admitted to the Clinic of Vascular Surgery. We observed 36 surgical complications: arterial thrombosis--7, venous thrombosis--1, arterial stenosis--7, lymphocoele--4, hematoma--4, ureteral fistula--6, ureteral stricture--6, ureterolithiasis--1. We undertook following surgical interventions: vascular reconstruction, thrombectomy, lymphocoele punction, fenestration towards peritoneal cavity, reimplantation techniques (a modo Gregoari, Boeminghausi, Boari), termino-terminal anastomosis with native ureter, uretero-enteric anastomosis, ESWL of ureteral stone. Renal transplantation complications requiring surgical interventions are serious urological problem. The severity, the type (vascular, liquid collection, urological), and the diagnosis of these complications determine patients' prognosis. Urgent surgical interventions lead to rapid recovery of graft function, eradication of the infection, amelioration of blood flow, and improved graft survival.