Simultaneous pediatric kidney transplantation and ureterocystoplasty in a 20-month-old boy.
Kidney transplantation (KT) in children with end-stage renal disease and an abnormal bladder poses a complex management challenge. Ureterocystoplasty (UC) has been previously reported in older children with non-compliant bladders, but the timing and technique of repair are controversial. This case reports the youngest patient, a 20-month-old boy to undergo successful single-stage UC and living-related KT. UC was performed because of a fibrotic, non-compliant bladder. A temporary vesicostomy was placed to provide adequate drainage in the presence of urethral stenosis. The patient developed a single episode of pyelonephritis within the first six months post-operatively, but there were no other urologic complications. At 13 months, the renal function is excellent with a mean glomerular filtration rate of 100 mL/min/1.73 m(2) and no clinical evidence of rejection. This case demonstrates that simultaneous UC and KT can be safely performed even in infants with non-compliant bladders and renal failure.
Ojogho
O N
ON
Transplantation Institute, Loma Linda University Medical Center, Loma Linda, CA 92354, USA. oojogho@llu.edu
Ben-Youssef
R
R
Chen
L J
LJ
Baron
P W
PW
Franco
E S
ES
Baldwin
D D
DD
D005355:Fibrosis / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery*; D001743:Urinary Bladder / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D014567:Urography; D013520:Urologic Surgical Procedures / Q000379:methods*