Vesicoureteral Reflux and Urinary Tract Infections in Renal Transplant Recipients

Kidney transplant in pediatric patients with severe bladder pathology

“…Two separate studies in which VCUG were routinely performed at one yr post‐transplant have shown a higher incidence of UTI in children with VUR. Pyelonephritis was seen in 23% and 37% of recipients with reflux, compared with 0% and 5% of recipients without reflux . In our cohort, most patients with VUR to the graft were managed medically with prophylactic antibiotics, except for three patients with SBP and four with NB who underwent ureteric reimplantation using an intravesical Cohen technique, due to the severity of symptoms despite medical treatment.…”

Introduction: Infections in Solid Organ Transplantation

“…Technical problems affecting the vascular supply and functional integrity of the allograft are major risk factors for infectious complications that manifest after the transplantation. Examples of specific technical problems associated with infection include thrombosis of the hepatic artery after liver transplantation ; vesicoureteral reflux after renal transplantation and mediastinal bleeding requiring re‐exploration in thoracic transplantation. These complications have been associated with hepatic abscesses and blood stream infection , graft pyelonephritis and mediastinitis, respectively .…”

“…Examples of specific technical problems associated with infection include thrombosis of the hepatic artery after liver transplantation ; vesicoureteral reflux after renal transplantation and mediastinal bleeding requiring re‐exploration in thoracic transplantation. These complications have been associated with hepatic abscesses and blood stream infection , graft pyelonephritis and mediastinitis, respectively . The ongoing presence of uncorrected technical problems can predispose to multiple episodes of recurrent infections until these issues are corrected.…”

Management of vesico‐ureteral reflux in renal allografts transplanted into pediatric recipients

“…The contribution of Fontana et al ( 1) is timely and welcome because there is little documentation in the literature on the consequences and management of vesico‐ureteral reflux in pediatric recipients of kidney transplants ( 2–4). In contrast, there is considerable literature evaluating post‐transplant reflux in adults and non‐transplant primary reflux in children.…”

“…In contrast, there is considerable literature evaluating post‐transplant reflux in adults and non‐transplant primary reflux in children. The available literature regarding reflux in pediatric kidney recipients suggests that there is an increased incidence of urinary tract infection (UTI) and pyelonephritis with reflux ( 2–4). In one series, pyelonephritis was present in 82% of UTIs in children with reflux vs. only 14% of UTIs in children without reflux ( 2), while in another series all young children with acute pyelonephritis had moderate to massive reflux ( 3).…”