Relevant issues following kidney transplantation include urine leakage and ureteral stenosis. There is currently no accepted definition of ureterovesical anastomosis issues following kidney transplantation. This study was created to show the quantitative Indocyanine Green (ICG) fluorescence angiography's prediction ability. 196 kidney transplantations were included in this bicentric historical cohort analysis, which was carried out between November 2015 and December 2019. In the context of donor, recipient, periprocedural, and postoperative features, the relationships between quantitative perfusion parameters of near-infrared fluorescence angiography with ICG and the occurrence of various grades of ureterovesical anastomosis problems were assessed. In 18% of cases, ureterovesical anastomosis problems followed the transplant. Three categories of complications have been established and graded. They had a connection to the length of time spent on dialysis (p = 0.0025), the kind of donor (p = 0.0404), and the quantity of postoperative dialysis sessions (p = 0.0173). In patients with complications, the median ICG ingress at the proximal ureteral third was 14.00 (5.00-33.00 AU) whereas in patients without issues, it was 23.50 (4.00-117.00 AU) (p = 0.0001, cutoff: 16 AU, sensitivity: 70%, specificity: 70%, AUC: 0.725, p = 0.0011). In order to allow for accurate comparisons between research, the recommended definition and grading of post-transplant ureterovesical anastomosis problems has been developed. ICG Fluorescence Angiography enables quantitative intraoperative evaluation of ureteral microperfusion after kidney transplantation and has the ability to foretell the likelihood of difficulties with ureterovesical anastomosis.
