Renal Transplantation in Children With Severe Bladder Dysfunction

Abstract

Renal transplantation in children with severe bladder dysfunction can achieve similar results to those obtained in the general population. Meticulous selection of patients and surgical reparative techniques ensuring voiding and adequate control of urinary infections are mandatory. Augmentation cystoplasty and intermittent catheterization are appropriate techniques currently used for achieving this outcome.

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

“…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.…”

Kidney transplantation in a child with bladder dysfunction who underwent prior bladder augmentation: A case report

“…Bunda, yaygın yerleşik kanı olarak büyütülmüş mesaneye yapılan böbrek naklinin, graft yaşamını kötü yönde etkileyen bir risk olduğu inancı önemli rol oynamaktadır. Buna karşın literatürde bir çok seride uygun bir mesane büyütme (augmentation) ameliyatı sonrası yapılan böbrek nakli ile normal mesaneye yapılan böbrek nakline ait graft yaşam süreleri karşılaştırıldığında her iki grup arasında anlamlı bir fark gösterilememiştir (1,3,4,5,7) . Büyütülmüş mesane ile birlikte TAK yapan olgularda artmış bir İYE riski söz konusu olabilir (3,4) .…”

“…Bu zorlukların en başında uygun kapasite, kompliyans ve işlevi olmayan çoğu nörojenik kökenli mesaneye sahip hasta grubuna, en seçkin renal replasman tedavisi (RRT) olan böbrek naklinin uygulanma süreci ve kararı gelmektedir. Günümüzde cerrahi ve medikal tedavilerde gelişmeler sayesinde bu hastalarda mesane büyütücü girişimler (augmentation) yapılarak uygun mesane hacmi ve optimal basınç sağlanabilmektedir (4) .…”

Pediatric Kidney Transplant in Uropaties

“…Reports have shown that this event has no effect on the survival of the graft (Warhom et al, 1999;Hatch et al, 2001). However, some authors believe that when pyelonephritis and recurrent episodes of asymptomatic UTI appear, the function of the graft is at risk, with the subsequent possibility of extirpation (Mendizabal et al, 2005;Alfrey et al, 1997). Other authors claim that recipients of the renal transplant with repeated UTI episodes show deterioration of the graft function, although its survival does not differ from the survival rate of the general population (Sullivan et al, 2003;Surange et al, 2003).…”