The Use of Autologous Platelet-rich Plasma in Ureterocystoanastomosis

A BSTRACT Urological complications, particularly ureterocystoanastomosis (UCA) failure, remain a significant concern following kidney transplantation, often resulting from ischemic necrosis of the distal ureteral segment. Platelet-rich plasma (PRP) has demonstrated regenerative properties, including enhanced angiogenesis, reduced inflammation, and improved tissue healing. This study aimed to evaluate the effectiveness of PRP in preventing UCA failure in kidney transplant recipients. A single-center, retrospective controlled study was conducted between July 2020 and December 2023. A total of 60 kidney transplant recipients were included, with 30 patients receiving PRP application at the UCA site (PRP group) and 30 serving as controls (no PRP). PRP was prepared from autologous blood, centrifuged, and applied as a gel to the anastomotic site. Postoperative clinical and laboratory parameters were compared between the groups, including urinary leakage rates, renal function, and length of hospital stay. No significant differences were observed in baseline characteristics between groups. UCA failure occurred in 6 patients (20%) in the control group, whereas no anastomotic failures were observed in the PRP group ( P = 0.028). The first episode of urinary leakage in the control group occurred on postoperative days 7–9, with two patients requiring surgical reanastomosis. PRP application was associated with improved anastomotic integrity and reduced postoperative complications. Autologous PRP application during UCA in kidney transplantation significantly reduces anastomotic failure rates. PRP may serve as a promising adjunct to improve surgical outcomes and graft survival in renal transplantation. Further large-scale studies are warranted to confirm these findings.