Endoscopic antireflux surgery leading to obstruction in pediatric renal transplant patients

Gina Cambareri, Christina Carpenter, Jeffrey Stock, Jane Lewis, Sarah Marietti

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


To describe a multicenter experience with management of ureteral obstruction after injection of Dx/HA for VUR in pediatric renal transplant patients. The records of all pediatric renal transplant patients who underwent Dx/HA injection for VUR and had subsequent obstruction were identified, and the management and outcomes were reviewed. Follow-up ranged from 1 to 10 years. There were four patients identified, all of whom had a history of rising creatinine, recurrent UTI, and increasing hydronephrosis which led to the diagnosis of high-grade VUR. Obstruction was diagnosed within 24-72 hours after injection in three patients. One patient was asymptomatic, and rising creatinine and hydronephrosis were noted 1 month after injection. One patient was managed expectantly, while three patients underwent ureteral stent placement. After the stent was removed, one patient went on to open reimplant due to delayed obstruction, the second patient with voiding dysfunction is currently managed with an indwelling ureteral stent and may require further definitive surgery, the third patient recovered, and the fourth is being observed. Our cases illustrate that despite initial successful management of the obstruction in some, delayed obstruction is possible and may necessitate open reimplant. It is imperative that these patients have close follow-up after Dx/HA.

Original languageEnglish (US)
Article numbere12838
JournalPediatric transplantation
Issue number1
StatePublished - Feb 1 2017

Bibliographical note

Publisher Copyright:
© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd


  • dextranomer/hyaluronic acid
  • obstruction
  • pediatrics
  • renal transplant
  • vesicoureteral reflux


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