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Outcome of renal transplant in patients with abnormal urinary tract

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Abstract

Purpose

To determine whether surgical procedures of the lower urinary tract in patients with uropathies affect evolution of the graft in renal transplantation.

Methods

156 kidney transplantations were performed in 150 patients with end-stage renal failure due to urologic disorders. The patients were classified into three groups: A, patients who did not require surgery in the lower urinary tract; B, required surgery and preserved adequate bladder function, and C, required surgery due to vesical dysfunction.

Results

Graft survival rates at 1 year were 93.38% in group A, 95.45% in group B and 93% in group C. Rates at 5 years post-transplantation were 82.45, 79.85 and 86.58% for each group, respectively (not significant). Complications were vesicoureteral stenosis: 2 in group A, 3 in B and 1 in C; vesicoureteral reflux: 1 in group A, 1 in B and 10 in C; distal ureteral necrosis: 2 cases in group A, 2 in B and 1 in C; upper urinary tract infection: 12, 23.1 and 42.2% in each group, respectively.

Conclusion

Children with reconstructed urinary tract may be good candidates for kidney transplantation despite the higher frequency of urinary infections. Thus, careful and strict post-surgical urologic follow-up is mandatory.

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References

  1. Koo HP, Bunchman TE, Flynn JT et al (1999) Renal transplantation in children with severe lower urinary tract dysfunction. J Urol 161:240–245

    Article  PubMed  CAS  Google Scholar 

  2. Sheldon CA, Gonzalez R, Burn MW et al (1994) Renal transplantation into the dysfunctional bladder: the role of adjunctive bladder reconstruction. J Urol 152:972

    PubMed  CAS  Google Scholar 

  3. Mitchell ME, Piser JA (1987) Intestinocystoplasty and total bladder replacement in children and young adult: follow-up in 129 cases. J Urol 138:579

    PubMed  CAS  Google Scholar 

  4. Broyer M, LeBihan C, Charbit M, Guest G, Tete MJ, Gagnadoux M et al (2004) Long-term social outcome of children after kidney transplantation. Transplantation 77:1033–1037

    Article  PubMed  Google Scholar 

  5. Salomon L, Fontaine E, Guest G et al (2000) Role of the bladder in delayed failure of kidney transplants in boys with posterior urethral valves. J Urol 163:1282

    Article  PubMed  CAS  Google Scholar 

  6. Shekarris B, Upadhyay J, Demirbilek S et al (2000) Surgical complications of bladder augmentation: comparison between enterocystoplasties in 133 patients. Urology 55:123

    Article  Google Scholar 

  7. Luke P, Herz D, Bellinger M et al (2003) Long term results of pediatric renal transplantation into a dysfunctional lower urinary tract. Transplantation 76:1578–1582

    Article  PubMed  Google Scholar 

  8. Barry J (2004) Kidney transplantation into patients with abnormal bladders. Transplantation 77:1120–1123

    Article  PubMed  Google Scholar 

  9. North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) (2007) Annual report

  10. Nahas WC, Lucon M, Mazzucchi E, Antonopoulos IM, Piovesan AC, David Neto E et al (2004) Clinical and urodynamic evaluation after ureterocystoplasty and kidney transplantation. J Urol 171:1428

    Article  PubMed  Google Scholar 

  11. Hitchcock RJ, Duffy PG, Malone PS (1994) Ureterocystoplasty: the bladder augmentation of choice. Br J Urol 73:575

    Article  PubMed  CAS  Google Scholar 

  12. Nahas C et al (2007) Comparison of transplantation outcomes in children with and without bladder dysfunction. A customized approach equals the difference. J Urol 179:712

    Article  PubMed  Google Scholar 

  13. Taghizadeh A (2007) Renal transplantation or bladder augmentation first? A comparison of complications and outcomes in children. BJU Int 100(6):1365–1370

    Article  PubMed  Google Scholar 

  14. Franc-Guimond J, Gonzalez R (2004) Renal transplantation in children with reconstructed bladders. Transplantation 77:1116–1120

    Article  PubMed  Google Scholar 

  15. Capizzi A et al (2004) Kidney transplantation in children with reconstructed bladder. Transplantation 77:1113–1116

    Article  PubMed  CAS  Google Scholar 

  16. Riley P et al (2010) Challenges facing renal transplantation in pediatric patients with lower urinary tract dysfunction. Transplantation 89:1299–1307

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank all the members of the Nephrology Department at Hospital de Pediatría Dr. Juan P. Garrahan for their collaboration.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Urology Department, Hospital de Pediatría Dr. Juan P. Garrahan, Combate de los Pozos 1881, CP 1245, Buenos Aires, Argentina

    Cristian Sager, Carol Burek, Víctor Durán, Juan Pablo Corbetta, Santiago Weller, Enrique Paz & Juan Carlos López

Authors
  1. Cristian Sager
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  2. Carol Burek
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  3. Víctor Durán
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  4. Juan Pablo Corbetta
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  5. Santiago Weller
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  6. Enrique Paz
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  7. Juan Carlos López
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Corresponding author

Correspondence to Cristian Sager.

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Sager, C., Burek, C., Durán, V. et al. Outcome of renal transplant in patients with abnormal urinary tract. Pediatr Surg Int 27, 423–430 (2011). https://doi.org/10.1007/s00383-010-2704-4

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  • DOI: https://doi.org/10.1007/s00383-010-2704-4

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