Strategies to treat children with end-stage renal dysfunction and severe lower urinary tract anomalies for receiving a kidney transplant.
Dealing with children with bladder dysfunction and kidney transplant is certainly not a new issue. Nevertheless, it is still a matter of discussion and dilemma, based on few, not standardized, institutional center experiences. The authors perform a review of the techniques employed to restore the bladder condition in terms of storage and drainage of urine to receive a kidney transplant in a safer condition. Aspects of the etiology and the way of evaluation of such a group of patients are discussed. The strategies and individualized therapeutic options are presented and compared with the author's experience based upon 25 children with urinary anomalies who received 28 kidney transplants. Nevertheless, the number of complications, mainly UTI, graft and patient survival rates are equivalent to the group of children with non-urological causes of ESRD. Patients with severe lower urinary tract abnormalities and ESRD may receive a kidney transplant with comparable success.
Nahas
Wlliam C
WC
Division of Urology, Renal Transplant Unit, University of Sao Paulo, Sao Paulo, Brazil. wnahas@uol.com.br
David-Neto
Elias
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D013997:Time Factors; D001743:Urinary Bladder / Q000002:abnormalities / Q000601:surgery; D014551:Urinary Tract / Q000002:abnormalities* / Q000601:surgery; D014570:Urologic Diseases / Q000150:complications / Q000628:therapy*; D013520:Urologic Surgical Procedures