J Korean Soc Transplant.  2008 Dec;22(2):220-225.

Experiences of Renal Transplantation after Correction of Dysfunctional Contracted Bladder

Affiliations
  • 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. sjkimgs@plaza.snu.ac.kr
  • 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 5The Transplantation Research Institute, Seoul National University, Seoul, Korea.

Abstract

BACKGROUND: There is some controversy about the safety of renal transplantation in patients with an augmentation cystoplasty. The purpose of this study is to assess the early and long-term results of renal transplantation in 6 patients who underwent augmentation cystoplasty to correct bladder dysfunction.
METHODS
We retrospectively reviewed the surgical outcome of renal transplants in 6 recipients with augmentation cystoplasty including one ileal conduit. The etiology of bladder dysfunction was neurogenic bladder with detrusor hyperreflexia (4 pediatric patients) and renal tuberculosis (2 adult patients). Augmentation cystoplasty was performed before transplantation in all patients. The bowel segments used in the augmentation cystoplasty included stomach in 2 (including one revision case with ileum), ileum in 3, ileocecal segments in 1, and sigmoid colon in 1 patients. The mean patient's age at transplantation was 25.5 years. Four transplants were from living donors. The donor ureter was anastomosed to ileal conduit in 1, native bladder in 2, and the bowel segment in 3 patients.
RESULTS
All transplanted kidneys were functioning at a mean follow-up of 103 months (range 5 to 220). The mean serum creatinine level was 1.0 mg/dl (range 0.7 to 1.8). Acute rejection was diagnosed in protocol biopsy in one patient without graft function deterioration. Four patients admitted for febrile urinary infection during the follow up periods.
CONCLUSIONS
Augmentation cystoplasty is a safe and effective method to restore the renal function in patients who have noncompliant bladders. Renal transplantation can be performed safely after augmentation cystoplasty.

Keyword

Renal transplantation; Dysfunctional bladder; Augmentation cystoplasty; Neurogenic bladder
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