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Renal transplantation in children with posterior urethral valves

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Abstract

The objective of this study was to analyze whether renal transplantation (RT) in children with posterior urethral valves (PUV) constitutes a special group with respect to groups with different etiologies of end-stage renal disease (ESRD). Between 1979 and 2004, 22 RT were performed in 19 children with PUV. The median age at RT was 10 years (range: 1.3–17). Immunosuppression was provided by triple therapy and polyclonal/monoclonal antibodies. This group was compared with the two control groups: (1) glomerulopathy (n=62) and (2) pyelonephritis/dysplasia (n=42) without lower urinary tract disease, transplanted in the same period. Ten graft losses occurred in 22 transplants: thrombosis (2), acute rejection (3), chronic graft nephropathy (2), and death of patients (3) with a functioning graft in the 1st postoperative month. We did not find significant differences versus the control group in renal function or probability of graft or patient survival at 1, 5, and 10 years. We observed a greater risk of urological complication in patients with PUV. RT with PUV constitutes a special group due to the compulsory young age and the need for careful and complex medicosurgical management; nevertheless, the results achieved were similar to those obtained in our general RT population.

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References

  1. Parkhouse HF, Barret TM, Dillon MJ, Duffy PG, Fay J, Ransley PG, Woodhouse CR, Williams DI (1988) Long-term outcome of boys with posterior urethral valves. Br J Urol 62:59–62

    Article  PubMed  CAS  Google Scholar 

  2. Tejani A, Brutt K, Glassberg K, Price A, Gurumurthy K (1986) Predictors of eventual end stage renal disease in children with posterior urethral valves. J Urol 136:857–860

    PubMed  CAS  Google Scholar 

  3. Drozdz D, Drozdz M, Gretz N, Möhring K, Mehls O, Schärer K (1998) Progression to end-stage renal disease in children with posterior urethral valves. Pediatr Nephrol 12:630–636

    Article  PubMed  CAS  Google Scholar 

  4. Haecker FM, Wehrmann M, Hacker HW, Stuhldreier G, von Schweinitz D (2002) Renal dysplasia in children with posterior urethral valves: a primary or secondary malformation? Pediatr Surg Int 18:119–122

    Article  PubMed  Google Scholar 

  5. Glassberg KI (2001) The valve bladder syndrome: 20 years later. J Urol 166:1406–1414

    Article  PubMed  CAS  Google Scholar 

  6. Jaureguizar E, Lopez-Pereira P, Martinez-Urrutia MJ (2002) The valve bladder: etiology and outcome. Curr Urol Rep 3:115–120

    Article  PubMed  Google Scholar 

  7. Salomon L, Fontaine E, Guest G, Gagnadoux MF, Broyer M, Beurton D (2000) Role of the bladder in delayed failure of kidney transplants in boys with posterior urethral valves. J Urol 163:1282–1285

    Article  PubMed  CAS  Google Scholar 

  8. Salomon L, Fontaine E, Gagnadoux MF, Broyer M, Beurton D (1997) Posterior urethral valves: long-term renal function consequences after transplantation. J Urol 157:992–995

    Article  PubMed  CAS  Google Scholar 

  9. Crowe A, Cairns HS, Wood S, Rudge CJ, Woodhouse CR, Neild GH (1998) Renal transplantation following renal failure due to urological disorders. Nephrol Dial Transplant 13:2065–2069

    Article  PubMed  CAS  Google Scholar 

  10. Bajpai M, Dave S, Gupta DK (2001) Factors affecting outcome in the management of posterior urethral valves. Pediatr Surg Int 17:11–15

    Article  PubMed  CAS  Google Scholar 

  11. Ylinen E, Ala-Houhala M, Wikström S (2004) Prognostic factors of posterior urethral valves and the role of antenatal detection. Pediatr Nephrol 19:874–879

    PubMed  Google Scholar 

  12. Denes ED, Spencer Barthold J, Gonzalez R (1997) Early prognostic value of serum creatinine levels in children with posterior urethral valves. J Urol 157:1441–1443

    Article  PubMed  CAS  Google Scholar 

  13. Churchill BM, Jayanthi RV, McLorie GA, Khoury AE (1996) Pediatric renal transplantation into abnormal urinary tract. Pediatr Nephrol 10:113–120

    PubMed  CAS  Google Scholar 

  14. Koo HP, Bunchman TE, Flynn JT, Punch JD, Schwartz AC, Bloom DA (1999) Renal transplantation in children with severe lower urinary tract dysfunction. J Urol 161:240–245

    Article  PubMed  CAS  Google Scholar 

  15. Gonzalez R (1997) Renal transplantation into abnormal bladders. J Urol 158:895–896

    Article  PubMed  CAS  Google Scholar 

  16. Hjälmas K (1988) Urodynamics in normal infants and children. Scand J Urol Nephrol Suppl 114:20–27

    PubMed  Google Scholar 

  17. Adams J, Mehls O, Wiesel M (2004) Pediatric renal transplantation and the dysfunctional bladder. Transpl Int 17:596–602

    Article  PubMed  CAS  Google Scholar 

  18. Ali-El-Dein B, Abol-Enein H, El-Husseini A, Osman Y, Shehab El-Din AB, Ghoneim MA (2004) Renal transplantation in children with abnormal lower urinary tract. Transplant Proc 36:2968–2973

    Article  PubMed  CAS  Google Scholar 

  19. Luke PP, Herz DB, Bellinger MF, Chakrabarti P, Vivas CA, Scantlebury VP, Hakala TR, Jevnikar AM, Jain A, Shapiro R, Jordan ML (2003) Long-term results of pediatric renal transplantation into a dysfunctional lower urinary tract. Transplantation 76:1578–1582

    Article  PubMed  Google Scholar 

  20. DeFoor W, Tackett L, Minevich E, McEnery P, Kitchens D, Reeves D, Sheldon C (2003) Successful renal transplantation in children with posterior urethral valves. J Urol 170:2402–2404

    Article  PubMed  Google Scholar 

  21. Nuininga JE, Feitz WFJ, van Dael KCML, de Gier RPE, Cornelissen EAM (2001) Urological complications in pediatric renal transplantation. Eur Urol 39:598–602

    Article  PubMed  CAS  Google Scholar 

  22. Fontaine E, Gagnadoux MF, Niaudet P, Broyer M, Beurton D (1998) Renal transplantation in children with augmentation cystoplasty: long-term results. J Urol 159:2110–2113

    Article  PubMed  CAS  Google Scholar 

  23. Hatch DA, Koyle MA, Baskin LS, Zaontz MR, Taylor RJ, Urologic Society for Transplantation and Vascular Surgery (2001) Kidney transplantation in children with urinary diversion or bladder augmentation. J Urol 165:2265–2268

    Article  PubMed  CAS  Google Scholar 

  24. Nahas WC, Mazzucchi E, Arap MA, Antonopoulos IM, Neto ED, Ianhez LE, Arap S (2002) Augmentation cystoplasty in renal transplantation: a good and safe option—experience with 25 cases. Urology 60:770–774

    Article  PubMed  Google Scholar 

  25. Mendizabal S, Estornell F, Zamora I, Sabater A, García Ibarra F, Simon J (2005) Renal transplantation in children with severe bladder dysfunction. J Urol 173:226–229

    Article  PubMed  CAS  Google Scholar 

  26. Landau EH, Jayanthi VR, McLorie GA, Churchill BM, Khoury AE (1997) Renal transplantation in children following augmentation ureterocystoplasty. Urology 50:260–262

    Article  PubMed  CAS  Google Scholar 

  27. Martin X, Aboutaieb R, Soliman S, El Assawy A, Dawahra M, Lefrancois N (1999) The use of long-term defunctionalized bladder in renal transplantation: is it safe? Eur Urol 36:450–453

    Article  PubMed  CAS  Google Scholar 

  28. Bartsch L, Sarwal M, Orlandi P, Yorgin PD, Salvatierra O Jr (2002) Limited surgical interventions in children with posterior urethral valves can lead to better outcomes following renal transplantation. Pediatr Transplant 6:400–405

    Article  PubMed  Google Scholar 

  29. Schurman S, McEnery PT (1997) Factors influencing short-term and long-term pediatric renal transplant survival. J Pediatr 130:455–462

    Article  PubMed  CAS  Google Scholar 

  30. Connolly JA, Miller B, Bretan PN (1995) Renal transplantation in patients with posterior urethral valves: favourable long-term outcome. J Urol 154:1153–1155

    Article  PubMed  CAS  Google Scholar 

  31. Indudhara R, Joseph DB, Pérez LM, Diethelm AG (1998) Renal transplantation in children with posterior urethral valves revisited: a 10-year followup. J Urol 160:1201–1203

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Nephrology, La Fe Hospital of Valencia, Valencia, Spain

    Isabel Zamora, Maria Jose Sanahuja, Ezena Roman & Pedro Ortega

  2. Department of Pediatric Urology, La Fe Hospital of Valencia, Valencia, Spain

    Agustin Serrano, Carlos Dominguez & Fernando García Ibarra

  3. Servicio de Nefrología Pediátrica, Hospital La Fe, Avda Campanar 21, 46009, Valencia, Spain

    Santiago Mendizabal

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  1. Santiago Mendizabal
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  2. Isabel Zamora
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  3. Agustin Serrano
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  4. Maria Jose Sanahuja
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  5. Ezena Roman
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  6. Carlos Dominguez
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  7. Pedro Ortega
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  8. Fernando García Ibarra
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Correspondence to Santiago Mendizabal.

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Mendizabal, S., Zamora, I., Serrano, A. et al. Renal transplantation in children with posterior urethral valves. Pediatr Nephrol 21, 566–571 (2006). https://doi.org/10.1007/s00467-006-0032-7

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  • DOI: https://doi.org/10.1007/s00467-006-0032-7

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