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Published on: April 28, 2013
Nephrostomy in early posttransplantation period in patients with nonfunctional graft and nondilated collecting system
Jan H Peregrin1, Vladimír Hanzal, Marcela Bürgelová
1Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021, Prague 4, Czech Republic, jape@medicon.cz.
Background:
The purpose of our study was to determine whether renal function can be restored by early nephrostomy in patients who fail to develop renal function immediately after transplantation.
Methods:
Between 2001 and 2010, we have performed external/internal nephrostomy in 13 patients during the early posttransplant period. The reason for the procedure was graft nonfunction with oliguria/anuria in the presence of normal renal perfusion, absence of signs of rejection, and/or renal collecting system dilation. The nephrostomy was created under ultrasound/fluoroscopic guidance.
Results:
Nephrostomy was technically successful in all cases. On days 1-3 following nephrostomy creation, 10 of 13 patients showed an increase in diuresis and subsequent graft function development. Once the obstruction had been removed, the graft remained functional for months up to years posttransplantation. Three patients failed to respond to nephrostomy. There were no nephrostomy-related complications.
Conclusions:
Our study documents that, in patients who failed to develop graft function posttransplant for unknown reasons, nephrostomy may result in graft function development.
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Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...