Outcomes of living donor renal transplantation in children with lower urinary tract dysfunction: a comparative retrospective study

Saad, Ismail R.; Habib, E; ElSheemy, Mohammed S.; Abdelhakim, Mai; Sheba, Mostafa; Mosleh, Aziz; Salah, Doaa M.; Bazaraa, Hafez; Fadel, Fatina; Morsi, Hany A.; Badawy, Hesham

doi:10.1111/bju.13347

Cited by 26 publications

(43 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the fact that our patient numbers were small, our patient and graft survival rates are similar to those of other reports (12)(13)(14). No patient or graft was lost to urological and/or surgical complications after transplantation.…”

Section: Discussionsupporting

confidence: 86%

Renal Transplantation in Children with Lower Urinary Tract Dysfunction: A Single-Center Experience

Sozen

Fidan

Onur

et al. 2017

GMJ

View full text Add to dashboard Cite

Aim: To evaluate patient and graft survival, as well as the surgical risks of LUTD patients treated at Gazi University Transplantation Center. Renal transplantation in patients with lower urinary tract dysfunction (LUTD) of various origins remains challenging in the field of pediatric transplantation. Patients and Methods: Of 42 pediatric transplantation recipients treated since 2006, LUTD developed in five (12%). Videourodynamic tests were performed on all patients preoperatively, and postoperatively if required. The causes of urological disorders were: Posterior urethral valve (PUV) (n=3), PUV with a neurogenic bladder (n=1), and a meningiomyocele plus a neurogenic bladder (n=1). Continual intermittent catheterization (CIC) was required by three patients for bladder emptying. Three patients received kidneys from deceased donors and two patients received kidneys from living donors. All patients underwent calcineurine-based triple immunosuppressive therapy. No patient underwent pre-transplantation augmentation. Only one patient (with PUV and a neurogenic bladder) underwent an augmentation operation during transplantation surgery. We used the Haberal corner-saving suture technique for ureteral stenting combined with ureteroneocystostomic anastomosis. Results: The mean age at transplantation was 12.2±1.6 years (10-14 years). The median follow-up duration after transplantation was 101 months (68 to 110 months). Two of the five recipients developed BK virus nephropathy (BK). One of the grafts was lost to BK but the other retained normal functioning. No recipient developed urological or surgical complications after transplantation. Three grafts were lost [BK (n=1); chronic allograft nephropathy (n=2)] but the remaining two patients are doing well with median creatinine levels 1.1 mg/dL. The 1-, 3-, and 5-year patient and graft survival rates were: 100%, 100%, 100% and 100%, 100%, 60% respectively. Conclusion: Renal transplantation in children with a LUTD can yield longterm successful outcomes comparable to those in children with non-LUTD. Because of the high complication rates associated with these transplants, careful evaluation, surveillance, and management of pre/posttransplantation periods are essential to optimize these outcomes.

show abstract

Section: Discussionsupporting

confidence: 86%

Renal Transplantation in Children with Lower Urinary Tract Dysfunction: A Single-Center Experience

Sozen

Fidan

Onur

et al. 2017

GMJ

View full text Add to dashboard Cite

show abstract

“…Pre‐Tx preparation of the UT for the new graft was reported including NN and the type of management for LUTD when present. Our protocol for Pre‐Tx preparation of UT was previously described . VCUG, urodynamic studies, and cystoscopy were used for children with LUTD.…”

Section: Methodsmentioning

confidence: 99%

“…Bilateral NN (when indicated) was staged. One side was performed at the time of Tx while the contralateral nephrectomy was performed 1 month Pre‐Tx …”

Section: Methodsmentioning

confidence: 99%

“…Post‐transplant VCUG was not performed for all patients. It was selected for children with recurrent UTI especially if associated with hydronephrosis . If LUTD were suspected, urodynamic study was also performed to exclude high intravesical pressure as a cause of VUR.…”

Section: Methodsmentioning

confidence: 99%

“…Our protocol for Pre-Tx preparation of UT was previously described. 8 VCUG, urodynamic studies, and cystoscopy were used for children with LUTD. Tx was performed only if a low intravesical pressure (<30 cm H 2 O) was achieved with adequate capacity and drainage.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for urological complications following living donor renal transplantation in children

ElSheemy

Ghoneima

Aboulela

et al. 2017

Pediatric Transplantation

Self Cite

View full text Add to dashboard Cite

The aim of this study was to detect possible risk factors for UC and UTI following pediatric renal Tx and effect of these complications on outcome. One hundred and eight children who underwent living donor Tx between 2009 and 2015 were retrospectively included. Extraperitoneal approach was used with stented tunneled extravesical procedure. Mean recipient age was 9.89 ± 3.46 years while mean weight was 25.22 ± 10.43 kg. Seventy-three (67.6%) recipients were boys while 92 (85.2%) were related to donors. Urological causes of ESRD were present in 33 (30.6%) recipients (14 [13%] posterior urethral valve, 16 [14.8%] VUR, and 3 [2.8%] neurogenic bladder). Augmentation ileocystoplasty was performed in 9 (8.3%) patients. Mean follow-up was 39.3 ± 17.33 months. UC were detected in 10 (9.3%) children (leakage 4 [3.7%], obstruction 3 [2.8%], and VUR 3 [2.8%]) while UTIs were reported in 40 (37%) children. After logistic regression analysis, UC were significantly higher in children with cystoplasty (44.4% vs 6.1%; P = .001). UTIs were significantly higher in girls (51.4% vs 30.1%; P = .001) and in children with urological causes of ESRD (51.5% vs 30.7%; P = .049). UC and UTI were not significantly associated with increased graft loss or mortality. UC were significantly higher in children with cystoplasty while UTIs were significantly higher in girls and children with urological causes of ESRD. Presence of UC did not affect the rate of graft loss or mortality due to its early detection and proper management.

show abstract

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

View full text Add to dashboard Cite

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.

show abstract

Outcomes of living donor renal transplantation in children with lower urinary tract dysfunction: a comparative retrospective study

Cited by 26 publications

References 41 publications

Renal Transplantation in Children with Lower Urinary Tract Dysfunction: A Single-Center Experience

Renal Transplantation in Children with Lower Urinary Tract Dysfunction: A Single-Center Experience

Risk factors for urological complications following living donor renal transplantation in children

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

Contact Info

Product

Resources

About