Outcome of renal transplantation in adult patients with augmented bladders

Transplant Proc. 2009 Jul-Aug;41(6):2382-4. doi: 10.1016/j.transproceed.2009.06.106.

Abstract

Objective: We studied the long-term renal graft functions, survivals, and complications among patients with augmented bladders.

Patients and methods: Between 1976 and 2008, we performed 6/2600 renal transplantations in patients with augmented bladders. The mean patient age was 52 years. The cause of end-stage renal disease was chronic interstitial kidney disease in all patients, being secondary to lower urinary tract dysfunction. The etiology of bladder dysfunction was tuberculosis in 4 cases, bladder exstrophy in 1, and myelomeningocele in 1. Enterocystoplasty had been performed at a mean of 19 years prior to transplantation. The ureter was implanted into the native ureter in 5 cases and the bowel segment in 1 case.

Results: With a mean follow-up of 56 months (range, 20-100 months), the overall graft survival was 50%. Three grafts were lost due to venous thrombosis (n = 1), and chronic allograft nephropathy (n = 2) at 37 and 100 months posttransplantation. No patient died during follow-up. Mean serum creatinine was 1.44 mg/dL with Modification of Diet in Renal Disease (MDRD) clearance of 76 mL/min/1.73 m(2). One fistula that caused obstructive uropathy and 2 cases of migration of a double J catheter were among the surgical complications. These patients showed a mean of 7 episodes of uncomplicated urinary infections. Only 1 patient was rehospitalized due to a complicated urinary tract infection.

Conclusions: Patients with enterocystoplasty and renal transplantation show a greater risk of urinary tract infections, albeit mostly uncomplicated. Despite this, the long-term results are acceptable.

MeSH terms

  • Adult
  • Aged
  • Cadaver
  • Female
  • Follow-Up Studies
  • Graft Survival / physiology
  • Humans
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods
  • Kidney Transplantation / physiology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tissue Donors
  • Treatment Outcome
  • Ureter / transplantation
  • Urinary Bladder / pathology*
  • Urinary Bladder / surgery
  • Urinary Bladder Diseases / complications*
  • Young Adult