Kidney transplantation before or after augmentation cystoplasty in children with high-pressure neurogenic bladder.
OBJECTIVE
To compare the outcome and complications of augmentation cystoplasty before or after renal transplantation in children with neurogenic bladders, with those after kidney transplantation in children with normal bladders.


METHODS
Augmentation cystoplasty preceded transplantation in 21 children (group 1) and after transplantation in 23 (group 2) operated from 1985 to 2006; these two groups were compared with a control group of 45 children with a normal bladder (group 3) who also received a transplant, for kidney function, episodes of urinary tract infection (UTI), surgical and medical complications.


RESULTS
The mean age of the three groups was 12.9, 13.2 and 13.6 years, respectively (P = 0.2). Graft survival at 1, 3, 5 and 7 years was 90%, 76%, 65% and 43% in group 1, 94%, 61%, 50% and 40% in group 2, and 94%, 87%, 81% and 75% in group 3, respectively, which was not significantly different between groups 1 and 2, but was higher in group 3 (P = 0.03). Febrile UTI was reported in five (24%), seven (30%) and one (2%) patients in groups 1-3, respectively. UTI was significantly less frequent in group 3 (P = 0.01) but was not different between groups 1 and 2. Acute rejection was reported in nine (43%), nine (39%) and 15 (33%) patients in groups 1-3, respectively (P = 0.2).


CONCLUSIONS
The timing of cystoplasty in relation to transplantation has no apparent significant effect on the outcome of transplantation.
Basiri
Abbas
A
Urology, UNRC, Shahid Beheshti University, MC, Tehran, Republic of Iran. basiri@unrc.ir
Otookesh
Hasan
H
Hosseini
Rozita
R
Simforoosh
Nasser
N
Moghaddam
Seyed Mohammadmehdi Hosseini
SM
D000293:Adolescent; D019072:Antibiotic Prophylaxis; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000601:surgery*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000517:prevention & control*
D007166:Immunosuppressive Agents