title: Long-term outcome of simultaneous or staged urinary diversion and kidney transplantation.
abstract: OBJECTIVE
  We retrospectively analyzed the long-term outcomes of simultaneous or staged urinary diversion and kidney transplantation.
  
  
  METHODS
  Between June 2001 and December 2012, 4 patients with dysfunctional bladder resulting from spina bifida (n = 3) or bladder contraction following urologic tuberculosis (n = 1) underwent cadaveric kidney transplantation and urinary diversion simultaneously (n = 3) or 6 months post-transplantation (n = 1). Urinary diversion consisted of cutaneous ureterostomy in 1 patient and ileal conduits in 3 patients. All patients were followed prospectively.
  
  
  RESULTS
  All 4 patients received deceased donor transplants. Median follow-up was 110.5 months (range 50-120). At the last follow-up, serum creatinine levels ranged from 1.1 to 1.8 mg/dl. One patient with a functioning graft died of severe cirrhosis 105 months following transplantation. Graft function remained stable without any severe complications in 3 patients. Hematoma (Clavien-Dindo grade IIIa) and urinary leakage (grade II) occurred in 1 patient in the early postoperative period, but no surgical revision was required. Two patients developed cytomegalovirus pneumonia. Urinary tract infection was a common problem in all patients.
  
  
  CONCLUSIONS
  For patients with lower urinary tract dysfunction, simultaneous kidney transplantation and urinary diversion with an ileal conduit may be a safe, feasible approach, with a satisfactory long-term outcome.
authors.affiliation: Department of Urology, Third Affiliated Hospital, Harbin Medical University, Harbin, China.
authors.forename: Lichen
authors.initials: L
authors.lastname: Teng
authors.forename: Changxi
authors.initials: C
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D003587:Cytomegalovirus; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D051437:Renal Insufficiency / Q000150:complications / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014552:Urinary Tract Infections / Q000517:prevention & control / Q000601:surgery; D014570:Urologic Diseases / Q000150:complications / Q000601:surgery; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003404:Creatinine