Renal transplantation in patients with spina bifida.
OBJECTIVE
Renal transplantation in patients with spina bifida is not commonly performed, although these patients have a high incidence of end-stage renal disease.


METHODS
Between February 1989 and December 1991, we performed 5 cadaveric renal transplants in 4 patients with spina bifida. There were 3 male patients and 1 female patient with a mean age of 22.5 years (range, 10 to 36 years). All patients had lumbar myelomeningoceles repaired shortly after birth. Three patients were wheelchair-bound due to their neurologic deficit. Prior to renal transplantation, management of neuropathic bladder dysfunction consisted of ileal conduit (1 patient), "clam" cystoplasty with clean intermittent self-catheterization (CISC; 1 patient), and CISC alone (2 patients).


RESULTS
In this series, 1 patient died of fungal septicemia 6 weeks postoperatively. One patient underwent transplantation again following primary nonfunction of his original allograft. Serum creatinine levels were 56, 91, and 120 mmol/L, respectively, after 18 months' follow-up.


CONCLUSIONS
This article demonstrates the feasibility of cadaveric renal transplantation in selected patients with end-stage renal failure and spina bifida. We currently recommend that these patients not be excluded from gaining the benefits of renal transplantation.
Little
D M
DM
Department of Urology and Transplantation, Beaumont Hospital, Dublin, Republic of Ireland.
Gleeson
M J
MJ
Hickey
D P
DP
Donovan
M G
MG
Murphy
D M
DM
D000293:Adolescent; D000328:Adult; D002102:Cadaver; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D012086:Reoperation; D016135:Spinal Dysraphism / Q000150:complications*; D016896:Treatment Outcome