[Kidney transplantation in patients with anomalies of the lower urinary tract].
In the transplant centre in Erlangen-Nuremberg, 1242 patients underwent renal transplantation between 1966 and 1993. In 4.5% of cases (56 patients) the renal end stage disease had been caused by severe abnormalities or functional disturbance of the lower urinary tract. Despite long-standing defunctionalization, urinary diversions and multiple operative procedures, it was possible to use the original bladder for ureterocystoneostomy in all patients. Only 1 patient needed an enterocystoplasty after transplantation. Altogether 72 transplantations have been performed in 56 patients ranging from 10.2 to 62.7 years of age. At follow up, 40 patients (71%) had a functioning graft with a mean serum creatinine level of 1.5 mg%. The 5-year transplant survival rate is 57.3%. Our results suggest that carefully planned renal transplantation in urological patients has results comparable to those obtained in other, non-risk, kidney transplant recipients. The methods of bladder reconstruction and augmentation, intermittent self-catheterization as well as anticholinergics and continuous antibiotic prophylaxis combine to make the ileal or colonic conduits needed earlier unnecessary.
Urologische Klinik, Universität Erlangen-Nürnberg.
W
W
Schafhauser
G
G
Schott
R
R
Kühn
H
H
Ruder
H H
HH
Neumayer
K M
KM
Schrott
D000293:Adolescent; D000328:Adult; D002648:Child; D003559:Cystostomy / Q000379:methods; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014546:Urinary Catheterization; D014547:Urinary Diversion / Q000379:methods; D014551:Urinary Tract / Q000002:abnormalities* / Q000601:surgery; D014567:Urography
Nierentransplantation bei Patienten mit Anomalien des unteren Harntraktes.