Renal transplantation into the abnormal lower urinary tract

Kidney Transplantation into Bladder Augmentation or Urinary Diversion: Long-Term Results

“…Previously, patients with severe lower urinary tract malformations had been excluded from renal transplant programs, as it appeared reasonable that a bladder that contributed to the destruction of the native kidneys would threaten a renal allograft (14,15). Enterocystoplasty or complete bladder replacement combined with CISC and suppressive antibiotic therapy as been shown to be an effective means to manage patients with refractory lower urinary tract dysfunction (5).…”

“…In fact, five (71.4%) of our seven patients with urinary incontinent diversion (Group 2) showed probability of graft survival of 83.3%, 55.5%, and 55% at 5, 10, and 15 years respectively with a mean of 110Ϯ12.9 months. Data from 55 renal allografts into enteric conduits show that 73% were functioning at a mean (range) of 7.8 (0.2-20) years later (14,25). Several other sin- gle-center and multicenter studies have reported similar graft survival values (14,24,25).…”

Is Bladder Cycling Useful in the Urodynamic Evaluation previous to Renal Transplantation?

“…If the native kidneys were damaged due to LUT abnormality, transplantation into the same bladder can be done only if there is evidence that it is a suitable site to drain the transplanted kidney [7,8] . Good results have been reported for RT done into abnormal bladders, provided that the dysfunctions had been detected and corrected prior to RT [9][10][11] .…”

Pediatric Kidney Transplant in Uropaties

“…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).…”

“…In some reports, instituting an aggressive treatment for UTI at an early stage post-transplant is recommended, since UTI may trigger acute rejection (Sullivan et al, 2003); other reports, however, suggest that intensive treatment in the case of asymptomatic UTI may favor the development of resistant bacteria strains. In our center, the approach followed consists of using as antibiotic prophylaxis trimetropin/sulfametoxazol even in the presence of positive urocultures in asymptomatic patients, without alteration of the function of the graft.…”