title: Kidney transplantation into bladder augmentation or urinary diversion: long-term results.
abstract: BACKGROUND
  We report on a single-institutional experience with renal transplantation in patients with severe lower urinary tract dysfunction (LUTD) who underwent bladder augmentation or urinary diversion, and assess the long-term results.
  
  
  METHODS
  From September 1987 to January 2005, 255 patients (161 male and 94 female), 7 months to 39 years old of age (median age at time of transplantation 14 years), received 271 kidney transplants. Etiology of end-stage renal disease was LUTD in 83 cases. Among these patients, 24 had undergone bladder augmentation or urinary diversion.
  
  
  RESULTS
  We identified two groups of patients surgically treated due to LUTD: group 1 included 16 patients (eight male, eight female) aged 4 to 39 years (median 19 years) with bladder augmentation, whereas in group 2, seven patients (five male, two female) 7 months to 31 years old (median 17 years) with incontinent urinary diversion were reported. In the first group, surgical complications after kidney transplantation included one urinary fistula, one ureteral stenosis. Three patients of second group developed recurrent urinary tract infection. Cumulative graft survival rates of all patients transplanted was 69.4% after 15 years, whereas in the two investigated groups, group 1 and group 2, was 80.7% and 55.5% respectively (P=NS.).
  
  
  CONCLUSIONS
  Drainage of transplanted kidneys into an augmented bladder or urinary diversion is an appropriate management strategy when the native bladder is unsuitable. Kidney transplantation in patients with bladder augmentation or urinary diversion for LUTD let achieve similar results to those obtained in the general population with normal lower urinary tracts.
authors.affiliation: Department of Urology, Section of Pediatric Urology, School of Medicine, University of Padova, Padova, Italy.
authors.forename: Waifro
authors.initials: W
authors.lastname: Rigamonti
authors.forename: Alfio
authors.initials: A
authors.lastname: Capizzi
authors.forename: Graziella
authors.initials: G
authors.lastname: Zacchello
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Capizzi
authors.forename: Giovanni Franco
authors.initials: GF
authors.lastname: Zanon
authors.forename: Giovanni
authors.initials: G
authors.lastname: Montini
authors.forename: Luisa
authors.initials: L
authors.lastname: Murer
authors.forename: Giacomo Passerini
authors.initials: GP
authors.lastname: Glazel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D019651:Plastic Surgery Procedures; D001743:Urinary Bladder / Q000601:surgery*; D014547:Urinary Diversion; D013520:Urologic Surgical Procedures