Outcome of renal transplantation in adult patients with augmented bladders.
OBJECTIVE
We studied the long-term renal graft functions, survivals, and complications among patients with augmented bladders.


METHODS
Between 1976 and 2008, we performed 6/2600 renal transplantations in patients with augmented bladders. The mean patient age was 52 years. The cause of end-stage renal disease was chronic interstitial kidney disease in all patients, being secondary to lower urinary tract dysfunction. The etiology of bladder dysfunction was tuberculosis in 4 cases, bladder exstrophy in 1, and myelomeningocele in 1. Enterocystoplasty had been performed at a mean of 19 years prior to transplantation. The ureter was implanted into the native ureter in 5 cases and the bowel segment in 1 case.


RESULTS
With a mean follow-up of 56 months (range, 20-100 months), the overall graft survival was 50%. Three grafts were lost due to venous thrombosis (n = 1), and chronic allograft nephropathy (n = 2) at 37 and 100 months posttransplantation. No patient died during follow-up. Mean serum creatinine was 1.44 mg/dL with Modification of Diet in Renal Disease (MDRD) clearance of 76 mL/min/1.73 m(2). One fistula that caused obstructive uropathy and 2 cases of migration of a double J catheter were among the surgical complications. These patients showed a mean of 7 episodes of uncomplicated urinary infections. Only 1 patient was rehospitalized due to a complicated urinary tract infection.


CONCLUSIONS
Patients with enterocystoplasty and renal transplantation show a greater risk of urinary tract infections, albeit mostly uncomplicated. Despite this, the long-term results are acceptable.
Blanco
M
M
Department of Urology, Doce de Octubre University Hospital, Madrid, Spain. maria.blanco@terra.com
Medina
J
J
Pamplona
M
M
Miranda
N
N
Gonzalez
E
E
Aguirre
J F
JF
Andres
A
A
Leiva
O
O
Morales
J M
JM
D000328:Adult; D000368:Aged; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome; D014513:Ureter / Q000637:transplantation; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000150:complications*; D055815:Young Adult