Transplantation of en bloc pediatric kidneys with a partial bladder segment in an adult recipient.
The success of transplantation of the urinary bladder en bloc with pediatric kidneys remains undetermined. We transplanted a large portion of the bladder with en bloc kidney allografts from a 13-month-old donor into a 45-year-old adult male. The recipient, who was on long-term hemodialysis, had a small urinary bladder consistent with long-standing anuria. Informed consent was given and bilateral kidneys were transplanted en bloc with both ureters and bladder. The patient's bladder was augmented with the donor bladder and bilateral ureteroneocystotomies of small ureters was avoided. At 3 and 18 months post-transplantation, cystoscopies revealed a viable bladder with new vessels and normal donor bladder. Cystogram revealed no reflux. The bladder segment was reperfused via blood supply from both ureters and then from the recipient's bladder. It seems that bladder transplantation en bloc with pediatric kidneys is a viable option for augmentation of a small recipient bladder that allows avoidance of very small bilateral ureteroneocystotomies.
Ciancio
Gaetano
G
The Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA. gciancio@med.miami.edu
Kato
Tomoaki
T
Chen
Linda
L
Sageshima
Junichiro
J
Livingstone
Alan S
AS
Burke
George W
GW
D000367:Age Factors; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009929:Organ Size; D011183:Postoperative Complications / Q000517:prevention & control; D014513:Ureter / Q000637:transplantation; D001743:Urinary Bladder / Q000637:transplantation*