Renal Transplantation in Patients with Posterior Urethral Valves: Favorable Long-Term Outcome

Connolly, John A.; Miller, Bulaklak; Bretan, Peter N.

doi:10.1016/s0022-5347(01)67016-2

Cited by 50 publications

(22 citation statements)

References 13 publications

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“…This finding is not shared by other authors who did not observe significant differences in patients with long-term outcome [30,31]. In our experience, although the number of patients with long-term disease duration was small, it does not seem to be a determining factor, since renal function assessed by plasma creatinine was similar to that observed in patients with other etiologies of ESRD ( Table 3).…”

Section: Discussionsupporting

confidence: 57%

Renal transplantation in children with posterior urethral valves

Mendizábal¹,

Zamora²,

Serrano

et al. 2006

Pediatr Nephrol

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The objective of this study was to analyze whether renal transplantation (RT) in children with posterior urethral valves (PUV) constitutes a special group with respect to groups with different etiologies of end-stage renal disease (ESRD). Between 1979 and 2004, 22 RT were performed in 19 children with PUV. The median age at RT was 10 years (range: 1.3-17). Immunosuppression was provided by triple therapy and polyclonal/monoclonal antibodies. This group was compared with the two control groups: (1) glomerulopathy (n=62) and (2) pyelonephritis/dysplasia (n=42) without lower urinary tract disease, transplanted in the same period. Ten graft losses occurred in 22 transplants: thrombosis (2), acute rejection (3), chronic graft nephropathy (2), and death of patients (3) with a functioning graft in the 1st postoperative month. We did not find significant differences versus the control group in renal function or probability of graft or patient survival at 1, 5, and 10 years. We observed a greater risk of urological complication in patients with PUV. RT with PUV constitutes a special group due to the compulsory young age and the need for careful and complex medicosurgical management; nevertheless, the results achieved were similar to those obtained in our general RT population.

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Section: Discussionsupporting

confidence: 57%

Renal transplantation in children with posterior urethral valves

Mendizábal¹,

Zamora²,

Serrano

et al. 2006

Pediatr Nephrol

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“…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%

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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“…Also in a study by Connolly and colleagues (1995), the mean age of patients at the time of kidney transplant was 16.3 years. 9,10 In contrast, patients with spina bifida tend to receive their renal transplant at older ages than those with bladder outlet obstruction at the PUV, as reported by several studies on patients with spina bifida. For example, in a study by Power and colleagues (2002), mean age at the time of transplant was 20.2 years (range, 10-35 y).…”

Section: Discussionmentioning

confidence: 99%

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Salman

Hassan²,

Sultan³

et al. 2017

Exp Clin Transplant

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Objectives: Successful kidney transplant depends partly on the normal physiologic functioning of the bladder, which involves effective urine storage and emptying. The bladder may become abnormal owing to various urologic and neuropathic disorders. Patients with abnormal bladders need careful management before and after transplant. In this study, we aimed to determine the outcomes of renal transplants in relation to various causes of abnormal bladder. Materials and Methods: We conducted a retrospective review of 25 patients with abnormal bladder who received 30 renal transplants between 1990 and 2014. The patients were divided into neurologic and urologic groups based on the causes of abnormal bladder. Patient demographics, graft function, survival, and postoperative complications were compared. Results: The most common urologic cause was posterior urethral valve (14 patients), while the most common neurologic cause was spina bifida (6 patients). There was no statistically significant difference in graft survival at 1, 3, and 5 years between patients with neurologic and urologic causes of abnormal bladder as well as at long-term follow-up. However, the mean estimated glomerular filtration rate at 1, 3, and 5 years was higher among patients with neurologic causes than in those with urologic causes, although the difference was statistically significant only at 1 year (61 ± 34 vs 37 ± 19 mL/min; P = .025). Stone formation was reported only in patients whose abnormal bladder had neurologic causes, and no incidence was reported in patients with urologic causes (20% vs 0%; P = .038). The incidence of other postoperative complications was not statistically significant between the 2 groups. Conclusions: With careful evaluation and proper preoperative correction of abnormal bladder dysfunction and optimization of the emptying and storage functions of the bladder, the causes of abnormal bladder did not appear to impact graft function and survival or overall rate of postoperative complications.

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Renal Transplantation in Patients with Posterior Urethral Valves: Favorable Long-Term Outcome

Cited by 50 publications

References 13 publications

Renal transplantation in children with posterior urethral valves

Renal transplantation in children with posterior urethral valves

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

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