Outcome of pediatric renal transplantation in urological versus non-urological causes of end stage renal disease: Does it matter?

Hussein, Ahmed A.; Shoukry, A; Fadel, Fatina; Morsi, Hany A.; Hussein, Hussein Aly; Sheba, Mostafa; El-Khateeb, Nada; Ela, Waseem Abou-El; ElSheemy, Mohammed S.; Daw, Kareem; Shouman, Ahmed; Lotfy, A.; Badawy, Hisham; Eissa, Mohamed

doi:10.1016/j.jpurol.2017.10.015

Cited by 12 publications

(16 citation statements)

References 25 publications

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“…The same was for occurrence of bleeding/significant hematoma, lymphocele, early AR episode, and infection. In comparison, Urinary leakage/ureteric fistula/bladder rupture was described in 23 cases in 10 studies where more frequency of occurrence was noticed in group of patient with LUTD 4.9% compared with 1.4% in groups with no LUTD 5,7‐12,15,16 . Only one study reported significant difference of urological complication due to severe bladder pathology included in this study 13 …”

Section: Discussionmentioning

confidence: 72%

“…Our study is an extension of two studies done at the same institute. However, those studies did not report the changes that occurred in the LUT function under renal graft 4,5 . In addition, we compared our results to 10 other studies on the outcomes of pediatric RT in patients with LUTD alone or compared to a control group with NLUT 6‐15 …”

Section: Discussionmentioning

confidence: 97%

“…Of the 12 studies, only one described a significant difference between the groups regarding donor age 5 . There were live‐related donors for only 62% of total cases, and nearly half of the donors were females (53.4%).…”

Section: Discussionmentioning

confidence: 99%

“…CIC was the most common needed measure to manage LUTD in 90 cases (46%) either alone or in combination with anticholinergic or augmentation. Main type of augmentation was ileocystoplasty in 62.7% of total augmented cases 4‐13,18 …”

Section: Discussionmentioning

confidence: 99%

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Does renal transplant in children with LUTD improve their bladder function?

Aboulela

Fawzy

Abdelmawla

et al. 2020

Pediatric Transplantation

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Much is still unknown about LUT function after receiving renal graft. Graft function was the main focus of different studies discussing the same issue. However, these studies ignored the effects of the graft on lower tract function and more demand for bladder cycling and growth of the child. Therefore, we aimed at evaluating the LUT function after RT into patients with LUTD. We enrolled a retrospective cohort of 83 live renal transplant children with LUTD. The 44 patients in Group (A) had a defunctionalized bladder, and the 39 patients in Group (B) had underlying LUT pathology. All patients had clinical and urodynamic evaluation of LUT functions at least 1 year after RT. We found that the improvement in patients with impaired bladder compliance was 73% in Group (A) and 60% in Group (B), with no statistically significant difference between the study groups. In Group (B), there was statistically significant worsening of MFP (8.4%) and mean PVR (79.9%) after RT. In Group (A), mild but stable significant improvement of all clinical and urodynamic parameters was observed. Serum creatinine was significantly worse in patients with pathological LUTD compared with those with defunctionalized bladder but without significant effect on graft survival. All LUT variables seemed to have no adverse effect on graft survival except for use of CIC and augmented bladder. Incident UTI independent of LUT variables accounted for 20% of graft creatinine change.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Does renal transplant in children with LUTD improve their bladder function?

Aboulela

Fawzy

Abdelmawla

et al. 2020

Pediatric Transplantation

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“…Unlike adult renal transplantation, the etiologies of pediatric ESRD are more commonly due to CAKUT, lower urinary tract dysfunction (neurogenic bladder, reflux, or posterior urethral valves), hereditary nephropathies, and glomerulonephritis . Patient survival rates within the first year of transplant have improved in recent years due to advancements in immunosuppression, surgical technique, organ allocation policies, and rates of living donor transplantation .…”

Section: Introductionmentioning

confidence: 99%

Clinical implication of renal allograft volume to recipient body surface area ratio in pediatric renal transplant

Chua

Kim

Gnech

et al. 2018

Pediatric Transplantation

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Our study aims to assess the clinical implication of RAV/rBSA ratio in PRT as a predictor for attained renal function at 1 year post‐transplantation and its association with surgical complications. A retrospective cohort was performed for PRT cases from January 2000 to December 2015 in our institution. Extracted clinical information includes the recipient's demographics, donor type, renal allograft characteristics, arterial, venous and ureteral anastomoses, vascular anastomosis time while kidney off ice, overall operative time, and estimated blood loss. The RAV/rBSA was extrapolated and assessed for its association with renal graft function attained in 1 year post‐transplantation and surgical complications within 30‐day post‐transplantation. A total of 324 PRTs cases were analyzed. The cohort consisted of 187 (52.4%) male and 137 (42.3%) female recipients, with 152 (46.9%) living donor and 172 (53.1%) deceased donor renal transplants, and an overall median age of 155.26 months (IQR 76.70‐186.98) at time of renal transplantation. The receiver operating characteristic identified that a RAV/rBSA ratio of 135 was the optimal cutoff in determining the renal graft function outcome. Univariate and multivariate analyses revealed the relative OR for RAV/rBSA ≥ 135 ratio in predicting an eGFR ≥ 90 attained within 1 year post‐transplant was highest among younger pediatric recipients (<142.5 months) of deceased kidney donors (OR = 11.143, 95% CI = 3.156‐39.34). Conversely, Kaplan‐Meier analysis revealed that RAV/rBSA ratio ≥ 135 is associated with lower odds of having eGFR <60 (OR = 0.417, 95% CI = 0.203‐0.856). The RAV/rBSA ratio was not associated nor predictive of transplant‐related surgical complications. Our study determined that the RAV/rBSA ratio is predictive of renal graft function at 1‐year PRT, but not associated with any increased surgical complications.

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On‐table urodynamic with ureteric occlusion: A resource for measuring bladder capacity and compliance in the management of patients with gross vesico‐ureteric reflux

Garriboli

Solomon

2021

Neurourology and Urodynamics

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To describe a technique for on-table urodynamic with ureteric occlusion (OUUO) and present a case series comparing bladder capacity and pressure measurements performed with and without ureteric occlusion in patients with gross vesico-ureteric reflux (grade ≥ IV VUR) to highlight the clinical utility. Methods: We performed OUUO in seven patients who were being considered for surgical management of VUR and/or nephro-ureterectomy. We occluded the refluxing ureters using hysterosalpingogram catheters (HSG, single lumen 5.5 Fr catheter with 1.5 ml balloon), guidewires, and rigid cystoscope. A 6 Fr dual-lumen urodynamic (UD) catheter is then inserted into the bladder to perform OUUO. Bladder capacity and Compliance (C = Δbladder volume/Δdetrusor pressure) are recorded and compared with values obtained at standard UD (without ureteric occlusion). Results:The age range of the seven patients was 2.0-15.5 years. The etiology for the gross VUR were posterior urethral valve (PUV) and neuropathic. The bladder capacity and compliance finding between UD and OUUO findings were comparable in five patients. However, there was a clinically significant difference in bladder capacity (20%-50% decrease) and compliance (50%-90%) between UD and OUUO findings in two out of seven patients. Conclusion:In the presence of gross VUR, OUUO allows for a potentially more accurate assessment of bladder capacity and compliance. OUUO should be considered when planning ureteric opening bulking/reimplantation and nephro-ureterectomy.

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Outcome of pediatric renal transplantation in urological versus non-urological causes of end stage renal disease: Does it matter?

Cited by 12 publications

References 25 publications

Does renal transplant in children with LUTD improve their bladder function?

Does renal transplant in children with LUTD improve their bladder function?

Clinical implication of renal allograft volume to recipient body surface area ratio in pediatric renal transplant

On‐table urodynamic with ureteric occlusion: A resource for measuring bladder capacity and compliance in the management of patients with gross vesico‐ureteric reflux

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