Continent Urinary Diversion in Preparation for Renal Transplantation

Riedmiller, H.; Gerharz, Elmar W.; Köhl, Ulrich; Weingärtner, K.

doi:10.1097/00007890-200012270-00009

Cited by 24 publications

(13 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our series, as in the majority of published series, most patients suffered from spina bifida . Constructing a continent reservoir allowed a population that already faces a disability to avoid the inconveniences of a non‐continent diversion, at a time when the desire to preserve body image played an increasing role in patient care.…”

Section: Discussionmentioning

confidence: 60%

“…Nevertheless, despite tried‐and‐true techniques and satisfactory functional results, few patients suffering from end‐stage renal disease have benefited from this type of diversion. In all, we found reports of 48 transplantations in adults with a continent pouch since 1989, with just four authors reporting more than two patients (Table ) …”

Section: Discussionmentioning

confidence: 97%

“…Some authors recommend the creation of the reservoir after kidney transplantation, when transplant function has been stabilized with minimal doses of immunosuppressive drugs. This approach would decrease the risk of lesions of the peritoneal folds during dissection, and would avoid the constraints of maintaining the reservoir in cases with no residual diuresis . In the present series, the reservoir was created before transplantation in all cases, with a minimum delay of 3 months.…”

Section: Discussionmentioning

confidence: 98%

See 2 more Smart Citations

Long‐term kidney transplant survival in patients with continent urinary diversion

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Long‐term kidney transplant survival in patients with continent urinary diversion

et al. 2017

View full text Add to dashboard Cite

show abstract

“…They concluded that the use of intestinal conduits for transplantation should be minimized because of the high incidence of septic complications (57). In recent reports, the incidence of complications ranged from 47% to 62.5% (58–60). A high incidence of UTI is well documented with supravesical diversion, and represents the most common complication.…”

Section: Strategies To Treat Patients With An Abnormal Lower Urinary mentioning

confidence: 99%

Strategies to treat children with end‐stage renal dysfunction and severe lower urinary tract anomalies for receiving a kidney transplant

Nahas¹,

David‐Neto²

2009

Pediatric Transplantation

View full text Add to dashboard Cite

Dealing with children with bladder dysfunction and kidney transplant is certainly not a new issue. Nevertheless, it is still a matter of discussion and dilemma, based on few, not standardized, institutional center experiences. The authors perform a review of the techniques employed to restore the bladder condition in terms of storage and drainage of urine to receive a kidney transplant in a safer condition. Aspects of the etiology and the way of evaluation of such a group of patients are discussed. The strategies and individualized therapeutic options are presented and compared with the author's experience based upon 25 children with urinary anomalies who received 28 kidney transplants. Nevertheless, the number of complications, mainly UTI, graft and patient survival rates are equivalent to the group of children with non-urological causes of ESRD. Patients with severe lower urinary tract abnormalities and ESRD may receive a kidney transplant with comparable success.

show abstract

“…Vor dem Hintergrund der guten Marburger/Würzburger Erfahrungen mit der Nierentransplantation in prätransplantationem angelegte Ileocoecalreservoirs bei insgesamt 12 Patienten mit aus verschiedensten Gründen geschädigten Harnblasen [29] erscheint es mir zumindest bei den oft wandverdickten, fibrosierten Harnblasen nach Urethralklappen risikoärmer zu sein, vor der Transplantation eine Blasenaugmentation oder ein kontinentes Reservoir mit Nabelstoma anzulegen. Da dem Schutz der Transplantatniere oberste Priorität gilt, ist in der Vorbereitung ein weitsichtiges Management sinnvoll.…”

Section: Schlussfolgerungunclassified

Die Problematik der Nierentransplantation bei Kindern und Jugendlichen mit Anomalien des unteren Harntraktes

Ebert¹,

Böswald²,

Schott³

et al. 2004

Aktuel Urol

View full text Add to dashboard Cite

Zusammenfassung Fragestellung: Die Nierentransplantation ist der beste Weg der Rehabilitation von Kindern mit terminaler Niereninsuffizienz. Dabei benötigen Kinder mit Anomalien des unteren Harntrakts intensive Betreuung schon vor der Transplantation. Bei unzureichender Speicherkapazität sowie hohen intravesikalen Drücken müssen neben konservativem Management mit intermittierendem (Selbst-) Katheterismus und Anticholinergikagabe auch Augmentationen oder Harnableitungen diskutiert werden. Der ideale Zeitpunkt und die Notwendigkeit einer operativen Rehabilitation ist umstritten. Material und Methode: Bei 26 terminal niereninsuffizienten Kindern mit Anomalien des unteren Harntraktes wurden die Spendernieren in die originäre Blase eingepflanzt. Eine präoperative Augmentation oder Harnableitung wurde in keinem Fall durchgeführt. Ergebnisse: Lediglich zwei Kinder benötigten im Verlauf bei verschlechterter Blasensituation eine Augmentation. Ein Prune-Belly-Kind konnte im Rahmen der Zweittransplantation mit Megaureter augmentiert werden. Bei einer Refluxpatientin mit vorbestehendem Ileumconduit bei neurogener Blase erfolgte eine Blasenaugmentation mit dem Conduit vier Jahre nach Transplantation. Schlussfolgerung: Unter engmaschiger Kontrolle können urologische Komplikationen und dadurch verursachter Transplantatverlust verhindert werden. Die meisten Blasen können unter konservativem Therapiekonzept mit intermittierendem (Selbst-) Katheterismus und Anticholinergikagabe rehabilitiert werden. Auch nach erfolgreicher Transplantation ist bei schlechter Blasenwandsituation die Augmentation ein sicheres Verfahren. Die primäre Harnableitung sollte auch in diesem Patientengut die Ausnahme bleiben. AbstractPurpose: Renal transplantation is the best way of rehabilitating children suffering from renal end stage disease. Children with congenital anomalies of the lower urinary tract need intensive evaluation and long-term care of the bladder situation before transplantation. Inadequate urine capacity or high intravesical pressure require further surgical management, such as augmentation, in addition to conservative management with anticholinergics and intermittent catheterisation. The optimal timing for urologic management for bladder rehabilitation is still controversial. Materials and Methods:In 26 children with renal end stage disease due to anomalies of the urinary tract, transplantation was performed into the native bladder. None of the patients underwent urinary diversion or pretransplant augmentation. Results: Only two children required augmentation after the bladder situation worsened. One boy with prune-belly-syndrome had a secondary transplantation with simultaneous ureterocystoplasty. In one girl with an ileum conduit for secondary neurogenic bladder, bladder augmentation using the ileum conduit as a bowel flap was performed 4 years after transplantation into her native bladder. Conclusions: Careful attention to congenital uropathy can greatly minimize the potential for complications and allograft loss. Most children with a...

show abstract

Continent Urinary Diversion in Preparation for Renal Transplantation

Cited by 24 publications

References 23 publications

Long‐term kidney transplant survival in patients with continent urinary diversion

Long‐term kidney transplant survival in patients with continent urinary diversion

Strategies to treat children with end‐stage renal dysfunction and severe lower urinary tract anomalies for receiving a kidney transplant

Die Problematik der Nierentransplantation bei Kindern und Jugendlichen mit Anomalien des unteren Harntraktes

Contact Info

Product

Resources

About