Transplantation into the Long-term Defunctionalized Bladder

Abstract

Renal transplantation into a long-term defunctionalized bladder can be performed safely in carefully selected patients. Bladder function and continence should be confirmed before transplantation using a program of progressive bladder rehabilitation.

The Use of Long-Term Defunctionalized Bladder in Renal Transplantation:Is It Safe?

“…In adults, a contracted bladder, if due primarily to prolonged defunctionalization, should also improve with restoration of the urinary flow [2]. Serrano et al [2]reported that bladders can be successfully restored after 26 years of defunctionalization.…”

“…In adults, a contracted bladder, if due primarily to prolonged defunctionalization, should also improve with restoration of the urinary flow [2]. Serrano et al [2]reported that bladders can be successfully restored after 26 years of defunctionalization. However, there may be instances in which chronic inflammation or previous surgery may cause extreme fibrosis leading to impaired bladder recovery, including chronic tuberculosis or schistosomiasis.…”

“…However, there may be instances in which chronic inflammation or previous surgery may cause extreme fibrosis leading to impaired bladder recovery, including chronic tuberculosis or schistosomiasis. In these particular cases bladder augmentation has a place [2]. The compatibility of intestinal diversions and bladder augmentations has been often documented [6, 7].…”

“…So we think that this technique is more practical for living-donor transplant, whose operation and rehabilitation can be planned. It was mentioned by Serrano et al [2]that continuous bladder cycling before transplantation remains the best way to rehabilitate, artificially, the prolonged defunctionalized bladder.…”

“…Patients with a long history of dialysis often develop small defunctionalized bladders. After transplantation, such bladders usually recover a good function [2]. However, at the time of transplantation, difficulties may appear, and ureteral reimplantation, whatever the technique is, can be hazardous, leading to complications.…”