Renal transplant in patients with spinal cord injuries.
OBJECTIVE
There is no knowledge on the outcome of renal transplant for end-stage renal disease secondary to neurogenic bladder caused by spinal cord injury. In this study, we evaluated the outcome of kidney allograft recipients with spinal cord injury.


METHODS
We evaluated graft survival, clinical course, laboratory findings, and imaging studies in 21 men (veterans) with spinal cord injury and renal failure secondary to neurogenic bladder. They underwent renal transplant between 1990 and 2006. Bladder dysfunction was appropriately managed before or with receiving the kidney allograft.


RESULTS
Mean (-/+ SD) age of patients was 43.8 -/+ 5.9 years. Mean glomerular filtration rate at the closing date of the study was 89.5 -/+ 33.6 mL/min. During follow-up (median: 6 years, range: 1-17 years), mean duration of graft survival was 15.4 -/+ 1.0 years (95% confidence interval, 13.2-17.5 years). Following renal transplant, mean nadir level of serum creatinine was 74.25 -/+ 16.79 micromol/L (0.84 -/+ 0.19 mg/dL). Six patients (28.6%) had kidney stones before renal transplant, and 2 patients (9.5%) after (1 patient with new kidney stones and 1 patient with kidney stones before and after transplant). Pyelonephritis occurred in 18 patients (85.7%) before transplant, and in 9 patients (42.9%) patients after (P = .07). Graft loss occurred in 2 patients (9.5%) 4 and 18 months after the transplant.


CONCLUSIONS
Spinal cord injury patients who receive allograft kidney transplants have acceptable outcomes, and transplantmay reduce urolithiasis and upper urinary tract infection.
Basiri
Abbas
A
Urology and Nephrology Research Center, Shahid Beheshti University, M.C., Tehran, I.R. Iran.
Shakhssalim
Nasser
N
Hosseini-Moghddam
Seyed Mohammadmehdi
SM
Parvaneh
Masoud Javadi
MJ
Azadvari
Mohaddeseh
M
D000328:Adult; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007492:Iran; D007669:Kidney Calculi / Q000209:etiology / Q000517:prevention & control; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology; D011704:Pyelonephritis / Q000209:etiology / Q000517:prevention & control; D011782:Quadriplegia / Q000209:etiology; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000601:surgery; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications* / Q000209:etiology / Q000601:surgery; D014728:Veterans
D003404:Creatinine