Kidney Transplantation in Children With Urinary Diversion or Bladder Augmentation

Hatch, David A.; Koyle, Martin A.; Baskin, Lawrence; Zaontz, Mark R.; Burns, Mark W.; Tarry, William F.; Barry, John M.; Belitsky, Philip; For, Rodney J. Taylor

doi:10.1016/s0022-5347(05)66181-2

Cited by 90 publications

(79 citation statements)

References 21 publications

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“…In our study, the patients with obstructive and reflux uropathy had a higher incidence of urinary obstruction, urinary reflux, urolithiasis and UTIs, as compared with matched controls. Our 45% incidence of urologic complications is higher than the 19-35% reported in the literature (5,9,12,17,21,27,28). We suspect this difference is, in part, due to our longer follow-up period and our use of a detailed data base.…”

Section: Discussionmentioning

confidence: 52%

“…Decreased graft function was reported for children with ESRD due to obstructive and reflux uropathy who underwent a KTx in the pre-cyclosporine (CSA) era (3). Reports of children with obstructive uropathy who underwent a KTx in the CSA era have been limited by small numbers of study patients, short follow-up periods, or lack of control patients (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). We report long-term KTx outcomes in a large group of children with ESRD due to obstructive and reflux uropathy who received maintenance immunosuppression with CSA.…”

Section: Introductionmentioning

confidence: 99%

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Increased Urologic Complications in Children After Kidney Transplants for Obstructive and Reflux Uropathy

Khositseth

Askiti

Nevins

et al. 2007

American Journal of Transplantation

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In the cyclosporine era, reports on pediatric kidney transplant (KTx) patients with obstructive and reflux uropathy are limited by small numbers, short followup, and/or lack of control groups. Our single-center study evaluated long-term outcomes (patient and graft survival, urinary tract infections [UTIs], urologic complications) in a large cohort of KTx recipients (<20 years old). We matched our 117 study patients with obstructive and reflux uropathy with 117 controls whose KTx was needed for other reasons; all 234 underwent their KTx between April 25, 1984, and October 23, 2002. The mean age was 8.0 ± 6.2 years; mean follow-up, 133 ± 67 months. The urologic complication rate was higher in study patients (43%) than in controls (11%) (p < 0.0001), as was the UTI rate (45% vs. 2%; p < 0.0001). The metabolic acidosis and UTI rates were higher in study patients who did (vs. did not) undergo bladder augmentation (p < 0.0001). We found no significant difference between study patients and controls in patient or graft survival, acute or chronic rejection, or mean estimated glomerular filtration rates. Unique to our study is the finding of higher metabolic acidosis and UTI rates in study patients who underwent bladder augmentation.

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Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Increased Urologic Complications in Children After Kidney Transplants for Obstructive and Reflux Uropathy

Khositseth

Askiti

Nevins

et al. 2007

American Journal of Transplantation

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“…Although urinary tract infections were frequent, they did not seem to affect the long-term function of the graft. 5,8 No urinary stones or chronic metabolic acidosis were observed in our patients.…”

Section: Discussionmentioning

confidence: 54%

“…As in most series, we performed bladder augmentation or an ileal conduit before the renal transplantation to decrease the risk of posttransplantation complications. 2,3,5,7,8 The most common cause of graft loss among our patients was immunologic. Although urinary tract infections were frequent, they did not seem to affect the long-term function of the graft.…”

Section: Discussionmentioning

confidence: 82%

“…3,4 Despite the increasing success of renal transplantation, as measured by patient and graft survivals. 5 urological disease may adversely influence outcome of this procedure due to urinary tract infection, surgical complications, allograft dysfunction, and graft loss. 6 Pretransplanta- tion assessment of lower urinary tract function is important.…”

Section: Discussionmentioning

confidence: 99%

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