PURPOSE: To study the short- and long-term outcomes of kidney transplantation in patients with a bladder augmentation or urinary diversion compared to patients with a kidney transplantation in a normal functional bladder.
PATIENTS AND METHODS: Between January 2000 and March 2011, 13 patients received 16 grafts into a reconstructed urinary tract. We performed a retrospective case-control study and matched each patient to 4 controls for donor and recipient gender and year of transplantation.
RESULTS: Short- and long-term complications of kidney transplantation occurred in 12 patients, varying from urinary tract infections to medical hospitalization with or without surgical or radiological intervention. In 5 patients, a percutaneous nephrostomy (PCN) was placed followed by surgical re-intervention. In three patients, the grafts failed as a result of chronic rejection and were re-transplanted. There was no graft loss as a result of surgical complications or the reconstructed urinary tract. One-year patient and graft survival was 100 %. After five years, all patients were alive and seven of nine grafts (77.8 %) were functioning. Mean follow-up time was 4.3 years. Among the controls, 55 grafts were transplanted in 52 patients. Ten patients received a PCN. Five patients needed surgical re-intervention. In three patients, transplantectomy was performed for ongoing rejection. Three patients were re-transplanted. One patient had a failing graft 7.5 years post-transplantation and became dialysis dependent.
CONCLUSION: Kidney transplantation in patients with a reconstructed urinary tract has an increased complication rate. Nevertheless, the long-term results are comparable to patients with a normal urinary bladder.
Written by:
Slagt IK, Ijzermans JN, Alamyar M, Verhagen PC, Weimar W, Roodnat JI, Terkivatan T. Are you the author?
Department of Surgery, Division of Transplant Surgery, Erasmus MC, University Medical Center, H-822 k, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Reference: Int Urol Nephrol. 2013 Apr;45(2):405-11.
doi: 10.1007/s11255-013-0395-1
PubMed Abstract
PMID: 23408323
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