Post-transplantation pyelonephritis: factors producing low patient and transplant morbidity

A retrospective study of 1,100 consecutive renal transplantations done on 959 patients revealed postoperative pyelonephritis in 15 patients, 14 of whom were women. Sixteen of the 20 episodes of pyelonephritis were caused by Escherichia coli and only 4 episodes occurred within the first year after transplantation, thus revealing the crucial differentiation from a rejection episode. When the etiology of the original renal failure was pyelonephritis the incidence of pyelonephritis in the transplanted kidneys was high. This high incidence also was true for cases associated with post-transplantation urological complications. When the etiology of renal failure was diabetes or polycystic renal disease, or when urologic abnormalities pre-existed the incidence of pyelonephritis was low. No transplant or patient loss was caused by post-transplantation pyelonephritis, probably because of prompt, correct diagnosis and a low urological complication rate.