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A systematic review of kidney transplantation outcomes in patients with end-stage renal disease due to childhood lower urinary tract malformations

  • Urology – Review
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Abstract

Purpose

Patients with lower urinary tract malformations (LUTM) were suspended from kidney transplantation (KT) programs in the past due to various concerns. Consequently, only a limited number of studies have explored this topic at hand. In this study, our objective was to perform a systematic review (SR) to evaluate the current evidence regarding KT outcomes as well as patient survival (PS), postoperative complications and urinary tract infections (UTI) in individuals with childhood LUTM.

Methods

The search encompassed databases of Web of Science, Medline (via PubMed), and Embase (via Scopus) to identify all studies reporting outcomes on KT for patients with LUTM. The research included articles published in English from January 1995 till September 2023.

Results

Of the 2634 yielded articles, 15 met the inclusion criteria, enrolling a total of 284,866 KT patients. There was significantly better 5-year graft survival (GS) in recipients with LUTM compared to the control group (RR, 1.04; 95% CI 1.02–1.06); while GS at 1-year and 10-year, and PS at 1-year, 5-year and 10-year were similar between groups. On the other hand, the postoperative UTI rate was significantly higher in the LUTM group (RR: 4.46; 95% CI 1.89–10.51). However, data on serum creatinine and estimated glomerular filtration rate on follow-up were insufficient.

Conclusion

GS and PS rates appear to be similar in patients with childhood LUTM and those with normal lower urinary tract functions. Despite a higher postoperative UTI rate within this patient group, it appears that this has no effect on GS rates.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

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Funding

None declared.

Author information

Author notes

  1. Hakan Bahadir Haberal and Muhammet Irfan Donmez have contributed equally to this article.

Authors and Affiliations

  1. Department of Urology, Ankara Ataturk Sanatorium Training and Research Hospital, Ministry of Health, University of Health Sciences, 06290, Ankara, Turkey

    Hakan Bahadir Haberal

  2. Department of Urology, Division of Pediatric Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey

    Muhammet Irfan Donmez

  3. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy

    Alberto Piana

  4. Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy

    Alessio Pecoraro & Riccardo Campi

  5. Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France

    Thomas Prudhomme

  6. Department of Urology, Renal Transplant Division, University Hospital Clínico San Carlos, Madrid, Spain

    Beatriz Bañuelos Marco

  7. Department of Urology, Virgen de La Arrixaca University Hospital, Murcia, Spain

    Alicia López-Abad

  8. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Riccardo Campi

  9. Department of Urology and Renal Transplantation, La Conception University Hospital, Marseille, France

    Romain Boissier

  10. Uro-Oncology and Kidney Transplant Unit, Department of Urology at “Fundació Puigvert” Hospital, Autonoma University of Barcelona, Barcelona, Spain

    Alberto Breda & Angelo Territo

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  1. Hakan Bahadir Haberal
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Consortia

EAU Young Academic Urologists (YAU) Kidney Transplantation Working Group

Contributions

Study concept and design: H.B.H., M.I.D., A.P., A.P., T.P., B.B.M., A.B., and A.T.; analysis and interpretation of data: H.B.H., M.I.D., and A.T.; drafting of the manuscript: H.B.H., M.I.D., A.P., A.P., T.P., B.B.M., A.L., R.C., R.B., A.B., and A.T.; statistical analysis: H.B.H. and M.I.D.; supervision: R.C., R.B., and A.B. All authors reviewed the manuscript.

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Correspondence to Hakan Bahadir Haberal.

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Haberal, H.B., Donmez, M.I., Piana, A. et al. A systematic review of kidney transplantation outcomes in patients with end-stage renal disease due to childhood lower urinary tract malformations. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-04079-5

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