title: Long-term outcome of kidney transplantation in patients with a urinary conduit: a case-control study.
abstract: OBJECTIVE
  To study the short- and long-term outcomes of kidney transplantation in patients with a bladder augmentation or urinary diversion compared to patients with a kidney transplantation in a normal functional bladder.
  
  
  METHODS
  Between January 2000 and March 2011, 13 patients received 16 grafts into a reconstructed urinary tract. We performed a retrospective case-control study and matched each patient to 4 controls for donor and recipient gender and year of transplantation.
  
  
  RESULTS
  Short- and long-term complications of kidney transplantation occurred in 12 patients, varying from urinary tract infections to medical hospitalization with or without surgical or radiological intervention. In 5 patients, a percutaneous nephrostomy (PCN) was placed followed by surgical re-intervention. In three patients, the grafts failed as a result of chronic rejection and were re-transplanted. There was no graft loss as a result of surgical complications or the reconstructed urinary tract. One-year patient and graft survival was 100 %. After five years, all patients were alive and seven of nine grafts (77.8 %) were functioning. Mean follow-up time was 4.3 years. Among the controls, 55 grafts were transplanted in 52 patients. Ten patients received a PCN. Five patients needed surgical re-intervention. In three patients, transplantectomy was performed for ongoing rejection. Three patients were re-transplanted. One patient had a failing graft 7.5 years post-transplantation and became dialysis dependent.
  
  
  CONCLUSIONS
  Kidney transplantation in patients with a reconstructed urinary tract has an increased complication rate. Nevertheless, the long-term results are comparable to patients with a normal urinary bladder.
authors: Department of Surgery, Division of Transplant Surgery, Erasmus MC, University Medical Center, H-822 k, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands. i.slagt@erasmusmc.nl
authors: Inez K B
authors: IK
authors: Slagt
authors: Jan N M
authors: JN
authors: Ijzermans
authors: Mustafa
authors: M
authors: Alamyar
authors: Paul C M S
authors: PC
authors: Verhagen
authors: Willem
authors: W
authors: Weimar
authors: Joke I
authors: JI
authors: Roodnat
authors: Türkan
authors: T
authors: Terkivatan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014547:Urinary Diversion; D055815:Young Adult