Partial bladder transplantation with en bloc kidney transplant--the first case report of a 'bladder patch technique' in a human.
Transplantation of the urinary bladder has not been reported in humans. We transplanted a portion of the donor bladder with an en bloc kidney graft in a 12-month-old girl. The child had a congenital hypoplastic single kidney with an ectopic ureteral opening into the vagina. Her native bladder was extremely small. Bilateral kidneys were transplanted en bloc with their ureters connected to a patch of the donor bladder, which encompassed the bilateral ureterovesical junctions (UVJs) (bladder patch technique). Approximately one-third of the donor bladder wall was used. The bladder patch reperfused well via blood supply from the ureters. Posttransplant cystoscopy with retrograde cystogram revealed a viable transplanted bladder with normal emptying of transplanted ureters. No reflux across the donor UVJs was seen in a voiding cystourethrogram. The child is doing well with normal renal function at 18-month follow-up.
Kato
T
T
Division of Transplant, University of Miami, Miami, FL, USA. tkato@med.miami.edu
Selvaggi
G
G
Burke
G
G
Ciancio
G
G
Zilleruelo
G
G
Hattori
M
M
Gosalbez
R
R
Tzakis
A
A
D005260:Female; D005500:Follow-Up Studies; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D016030:Kidney Transplantation / Q000276:immunology / Q000379:methods*; D016896:Treatment Outcome; D014513:Ureter / Q000002:abnormalities; D001743:Urinary Bladder / Q000002:abnormalities / Q000601:surgery* / Q000637:transplantation*
D007166:Immunosuppressive Agents